ESTRO meets Asia 2024 - Abstract Book

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Invited Speaker

ESTRO meets Asia 2024

The use of questionnaires and toxicity assessment scales have been the mainstay of reporting outcomes of treatment for many years. Traditionally these questionnaires were observer-based, and whilst still commonly used today, this approach has been criticised due to the lack of concordance between observer-rated or patient-rated events. This shortcoming has prompted the emergence of patient reported outcome measures (PROMs) which aim to capture patients’ perspective on treatment effects. The implementation of PROMs has been facilitated by the explosion of digital technologies integrated in healthcare today, resulting in the use of electronic PROMs (e-PROMs). One of the most used tools to record adverse events from cancer treatment is the CTCAE. In order to capture the effect of treatment on patients’ quality of life (QoL), among other endpoints, this system considers the impact on “activities of daily living”. Despite this, the observer-rated approach risks there being a disconnect between the healthcare practitioner and the patient. To reduce the risk of undervaluing the impact of treatment on patient QoL, several questionnaires have emerged addressing this domain separately. The EORTC Quality of Life Questionnaire (EORTC QLQ-C30) and its site-specific modules are prime examples here. The pioneering work of the EORTC, has motivated other groups to follow suit, and today we now have several tools which have given a voice to the patient perspective, ultimately contributing to the expansion of PROMs available. Often using a combination of Likert scales and free text responses, additional probing questions are intended to comprehensively capture the breadth of difficulties associated with specific adverse events. Given the sheer volume of data potentially recorded, digitisation of data collection and storage is a necessity. Here we refer to the use of e-PROMS. The electronic nature of this approach allows for conditional branching logic within the e-PROM to increase efficacy in reporting, whilst also allowing room for cancer specific considerations. Several industry partners have invested efforts into this technology with the intention of providing seamless integration of e PROMs into the existing radiation oncology workflow. Quality of life is multidimensional, and this can only be fully appreciated by capturing the voice of patients directly. The use of PROMS should not be confined to those enrolled on clinical trials but must be integrated into routine care of all our patients. Radiation oncology today must embrace ePROMs to exploit the potential for real-time monitoring, enhancing patient engagement and optimizing treatment outcomes. Only in doing so, will we be able to provide holistic, patient-focused healthcare.

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Global dialogue on PROMs

Jeffrey Tuan

Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore. ACP Oncology, Duke NUS Medical School, Singapore, Singapore

Abstract

I will describe a real-world example of using PROMs in a busy Radiation Oncology Centre in Singapore. The National Cancer Centre Singapore (NCCS) is the largest public cancer centre in the country. We see about 60% of all publicly funded cancer patients, which approximates to 10,000 a year. In the radiation oncology department, we see around 4,000 patients annually. We recognize the importance of PROMs in patient care as well as for health economic assessment, especially with the introduction of new and expensive technologies such as Proton Beam Therapy (PBT).