Head and Neck Cancer, Radiotherapy Side Effect
Conditions
Keywords
Patient-Reported Outcome, Quality of life, Electronic reporting of symptoms, Radiotherapy
Brief summary
Weekly electronic reporting of patient-reported outcomes will be tested in a national trial in participants undergoing radiotherapy for head and neck cancer. The study is a national study under the Danish Head and Neck Cancer Group (DAHANCA) and all 6 centers in Denmark will participate. The clinical endpoints will be: * Quality of life * Objective toxicity score (DAHANCA) * Opioid treatment * Tube feeding * Weight loss * Hospitalization * Compliance to treatment
Detailed description
There is a high level of evidence for improved disease control in head and neck cancer (HNC) using regimens with accelerated radiotherapy and concomitant chemotherapy. These intense regimens can result in severe acute and late side effect. The standard approach for documenting symptomatic adverse events (AEs) in cancer clinical trials involves investigator reporting using the National Cancer Institute's (NCI's) Common Terminology Criteria for Adverse Events (CTCAE). In Denmark, the Danish Head and Neck Cancer Group (DAHANCA) toxicity score has been used as an instrument in assessing objective treatment induced toxicity. New research in other cancer treatments indicate, that systematic patient assessment of side effects may improve treatment outcome. Patient Reported Outcomes (PROs) can be used for symptom monitoring. Interactive use of PRO may secure early recognition of specific symptoms in the individual patient and timely management of side effects. This trial it is a prospective nationwide, single armed sequential cohort study will investigate the effects of active use of PROs in clinical counselling and decision making during primary or post-operative curative radiotherapy for squamous-cell carcinoma of the head and neck (HNSCC). It will investigate quality of life and the management of side effects in standard clinical counselling (control group) versus standard clinical counselling plus the PRO (PRO group). The EORTC QLQ-C30 (quality of life questionnaire) and EQ-D5-L5 will be answered in both groups. In the PRO group the participants will be asked to complete the electronic PRO (PRO CTCAE™ HNC relevant items supplemented by HNC specific items fra the EORTC library) weekly. The electronic PRO questionnaire is designed to give feedback to treating physician and nurses at visits during and shortly after radiotherapy.
Interventions
OTHERElectronic Patient-Reported Outcome
Weekly reporting of patient-reported outcomes on a tablet for closer contact between patient and clinic during radiotherapy.
Sponsors
Danish Comprehensive Cancer Center
Danish Cancer Society
University of Copenhagen
Danish Head and Neck Cancer Group
Herlev Hospital
Zealand University Hospital
Odense University Hospital
Aalborg University Hospital
Aarhus University Hospital
Rigshospitalet, Denmark
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
A prospective nation-wide, sequential cohort study. * First phase control group. 97 participants. No Intervention: Standard of care.This arm will continue standard procedure regarding side effect registration and handling. * Second phase. PRO group. 194 participants. Intervention: Active use of electronic patient-reported outcomes.This arm will be assigned to intervention by weekly electronic reporting of side effects and quality of life.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Primary or post-operative curative radiotherapy (photons) plus/minus concomitant Cisplatinum for squamous-cell carcinoma of the head and neck (HNSCC) * No serious cognitive deficits * Read and understand Danish
Exclusion criteria
•Prior radiotherapy in the same area (head and neck)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life measured by EORTC QLQ C30 | With in the first 2 months | Registration of differences in quality of life between the two groups in the study. EORTC QLQ-C30(scale range 0-100, a higher score indicating better quality of life) will be used for as quality of life measurement. The scores will be presented graphically in separate figures. Differences between the groups will be tested using t-test and analysis of covariance. |
| Quality of life (QOL) measured by EuroQol EQ-5D-5L. | With in the first 2 months | EQ-5D-5L measures individual generic health status using 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and each dimension has 5 levels depending on severity of symptoms (1 no problems, 5 extreme problems) and a VAS (visual analogue scale). The scores can then be converted into a single index number. The index value will be used for calculation of quality-adjusted life years (QALYs) for a health economic analysis of the intervention. The scores will be presented graphically in separate figures. Differences between the groups will be tested using t-test and analysis of covariance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| DAHANCA toxicity score | Within the first 4 months | DAHANCA toxicity score is an objective grading of the patients symptoms by the clinician. Scale 0-4, where 0 is no/nothing and 4 is severe. Registration of differences in DAHANCA toxicity score and electronic PRO |
| Weight loss | Within the first 4 months | Registration of differences in weight loss in the two groups. |
| Hospitalization due to toxicity expect tube-feeding and patients reported experience | Within the first 4 months | Number of hospitalizations reported in the medical record at the control visit 2 months after end af radiotherapy |
| Compliance to cisplatinum | Within the first 2 months | Number of participants completing planned Cisplatinum |
| Time to opioid treatment | Within the first 3 months | Registration of differences in time to opioid treatment in the two groups |
| Time to tube-feeding/other feeding | Within the first 3 months | Registration of differences in time to Time to tube-feeding/other feeding in the two groups |
Countries
Denmark
Contacts
Primary ContactCecilie Holländer-Mieritz, MD
Backup ContactHelle Pappot, MD, DMSc
Outcome results
None listed