ESTRO 2024 - Abstract Book

S5682

RTT - Patient experience and quality of life

ESTRO 2024

Data was analysed from 368 consecutive LE patients when accessing SWRLES (1/8/22 until 31/7/23) with mixed diagnoses, covering a wide range of time (months) since diagnosis (range 3-657; average 67, median 27, mode 13; 55% patients were more than 18 months post-diagnosis). EQ-5D-5L results showed SWRLES patients had a consistently lower QoL (Visual Analogue Score; SWRLES 58.5/100, SWAG 76.4, NHS all-cancers 74.9, UK no-cancer 80.6), and lower average overall health summary scores (SWRLES 70/100, SWAG 75.9, NHS all-cancers 73.9, UK no-cancer 90.1), reporting more problems both overall and in severity in all five health aspects. EQ-5D-5L found 81% SWRLES patients reported pain (64% mild/moderate, 17% severe/extreme pain) compared to 60% SWAG patients, 62.2% NHS all-cancers and 27.3% UK no-cancer. QLQ-C30 results also found pain was the most prevalent symptom with 54% above a Threshold of Clinical Importance (TCI) who would benefit from further investigation [7]. Fatigue, poor sleep, diarrhoea and dyspnoea all scored above the TCIs and symptoms were worse compared to SWAG and national data. SWRLES patients scored lower (69.2) than SWAG (80.8) and NHS all-cancers (79.2) for QLQ-C30 summary scores, combining function and symptoms, indicating a poorer health related QoL. The QLQ-C30 self-rated QoL was also lower (SWRLES 57.8, SWAG 72.6, NHS all-cancers 71) and in proportion with the EQ-5D-5L results. QoL for people with RT LE is low compared to patients 18 months since diagnosis, patients reported worse symptoms and poorer function. Data is useful to evidence patient outcomes but may also be predictive. Recent research identified QLQ-C30 summary scores are prognostic for overall survival in different cancer populations [8] with a 10-point increase associated with a 23% lower risk of death. SWRLES patients scored 10 points lower than other cohorts. It is acknowledged the SWRLES results are limited by patient numbers and bias as LE patients seek help for debilitating symptoms. Conversely, large national datasets may actually hide or mask a small cohort of patients with specific needs such as LE patients. The NHS aspires to use QoL metrics to see ‘where care is working well, and ‘if any new services are needed’. This study highlights that routinely collected QoL data can be used to provide meaningful quantitative comparison, vital for LE services currently scarce and poorly funded. As SWRLES patient numbers increase, data regarding specific cancer types, time since diagnosis etc. will improve, providing a rich picture of the long-term effects of radiotherapy treatment on day-to-day life. Conclusion:

Keywords: Radiotherapy late effects, survivorship

References:

[1] Kyte D, et al. (2016). Current practices in patient-reported outcome (PRO) data collection in clinical trials: a cross-sectional survey of UK trial staff and management. BMJ Open 6:e012281. doi: 10.1136/bmjopen-2016 012281

[2] National Institute for Health and Care Excellence (2022). NICE health technology evaluations: the manual. Accessed online nice.org.uk/process/pmg36/chapter/economic-evaluation

[3] NHS Cancer Quality of Life Survey (2020). Accessed online cancerqol.england.nhs.uk