A federally funded randomized clinical trial of 357 patients undergoing radiation therapy for head and neck cancer using mobile and sensor technology to remotely monitor patient symptoms, resulting in less severe symptoms (both general and cancerous) associated with cancer and its treatment Correlation) .
of patients using this technology (including a Bluetooth-enabled scale, a Bluetooth-enabled blood pressure cuff, and a mobile tablet with a symptom-tracking app that sends a message directly to their doctor each weekday) Patients had less severe symptoms than participants who had to see a doctor every week. In addition, the researchers say that daily remote tracking of patients’ health allows doctors to detect symptoms earlier and respond more quickly than usual care. The findings will be presented at the upcoming 2018 ASCO Annual Meeting in Chicago.
“Our study provides evidence for how new technologies can be integrated into cancer care with relative ease and improve patient outcomes without impacting people’s daily lives,” said lead study author Susan K. Peterson, Ph.D., professor in the Department of Behavioral Sciences, Texas. University MD Anderson Cancer Center, Houston. “This study was done during a fairly stressful time for patients with head and neck cancer. The system helped their doctors provide valuable support, ultimately reducing the severity of symptoms. “
An estimated 51,540 new head and neck cancers will be diagnosed in the United States in 2018. 1 More than 10,000 people are expected to die from the disease, three-quarters of them men. Most people diagnosed with this type of cancer can receive radiation therapy, but chemotherapy or surgery can also be done. One of the main treatment side effects that requires careful monitoring is pain and difficulty swallowing, which can lead to dehydration. The trial used a technology system called CYCORE (CYberinfrastructure for Synergistic Efficacy Research), which was co-developed by the four institutions through funding from the National Cancer Institute.
Participants were randomly assigned to CYCORE (169) or usual care (188), which included weekly doctor visits. People in the CYCORE group received Bluetooth-enabled sensors (blood pressure cuffs and scales). They also get mobile tablets with proprietary Wi-Fi. The home wide area network (WAN) hub/router transmits its sensor readings, and the mobile app transmits its symptom data through the backend network infrastructure to secure the firewall-protected computers at MD Anderson, thereby ensuring the confidentiality of patient information.
For the CYCORE group, doctors remotely review data from apps and sensor transmissions every working day and intervene if necessary. Both CYCORE and usual care participants had weekly in-person visits.
At the start of radiation therapy, study participants completed a 28-item MD Anderson Symptom Checklist survey about their health and common activities of daily living. The survey covers general symptoms common to cancer patients, such as pain, fatigue and nausea, as well as symptoms that are particularly relevant to head and neck cancer patients, such as difficulty swallowing or chewing, skin pain/burn/rash, and problems with tasting food. Participants typically completed similar surveys at the end of radiation therapy 6 to 7 weeks later. Final surveys were completed 6 to 8 weeks after their radiation therapy ended.
There were no differences in self-reported health severity scores between CYCORE participants and those who received usual care at the start of the trial. Symptom severity was scored on a scale of 0 to 10, with 0 indicating no symptoms or pain and 10 being the highest level of symptom severity. After radiotherapy was completed, CYCORE participants had a lower mean score for general symptoms (i.e., better), while usual care participants had a lower mean score (2.9 vs. 3.4), and head and neck cancer-specific symptoms had a lower mean score (4.2 vs. 4.2). 4.8).
Six to eight weeks after completing treatment, CYCORE participants scored an average of 1.6 based on overall health, compared with 1.9 for usual care participants. Severity scores for specific head and neck symptoms were slightly higher in both groups (1.7 vs 2.1). Dr. Peterson noted that the majority of patients (80% or more) adhered to daily monitoring, a good outcome given the intensity of treatment. Scores reflecting how various symptoms affected activities of daily living were about the same in both groups throughout the reporting period.
Although the authors were able to recruit people of all ages, the majority of the study population was white, which fully reflects the overall head and neck patient population at the cancer center. The researchers’ next step may be to determine how long the benefits of the CYCORE intervention can last. They also hope to implement the CYCORE intervention in the non-academic cancer care setting where most cancer patients are treated.