2018 ASCO: Mobile and Sensor Technology May Lead to Reduced Symptom Severity in Patients With Head and Neck Cancer

Key Points

  • Patients randomized to the CYCORE group reported a lower severity of general and head and neck cancer–specific symptoms during radiation therapy compared with patients in the usual-care group. After completion of radiation therapy, the CYCORE group had lower mean scores for general symptoms compared with patients in the usual-care group (2.9 vs 3.4, respectively) and lower mean scores for symptoms specific to head and neck cancer (4.2 vs 4.8, respectively).
  • Sensor and mobile technology can enable the monitoring of symptoms and related outcomes during critical periods of outpatient cancer treatment; it can provide timely information to facilitate rapid clinical decision-making regarding patient care and may result in better quality of life and health outcomes.

A randomized clinical trial evaluating the use of mobile and sensor technology to remotely monitor symptoms in patients receiving radiation therapy for head and neck cancer found that use of this technology reduced severe symptoms related to cancer and its treatment compared with usual care. According to the investigators, using sensor and mobile technology can facilitate rapid clinical decision-making about care and may result in greater quality of life and health outcomes. The study was presented during a press briefing in advance of the upcoming 2018 ASCO Annual Meeting and will be reported by Peterson et al at the meeting (Abstract 6063).

Study Details

In this study, the researchers used a technology system called CYCORE (CYberinfrastructure for Comparative Effectiveness Research). The CYCORE system utilizes sensor and mobile technology, including a Bluetooth-enabled weight scale, a Bluetooth-enabled blood pressure cuff, and a mobile tablet with a symptom-tracking application.

The researchers randomized 357 patients with head and neck cancer receiving radiation therapy to either CYCORE (n = 169) or usual care (n = 188), which consisted of weekly physician visits. Patients ranged in age from 25 to 86 years; 21% were female, and 85% were white.

In addition to Bluetooth-enabled sensors, patients in the CYCORE arm received mobile tablets with proprietary Wi-Fi and an in-home wide-area network hub/router, which transmitted patients’ sensor readouts. The mobile app transmitted patients’ symptom data through a back-end cyber-infrastructure to secure firewall-protected computers at The University of Texas MD Anderson Cancer Center to ensure patient confidentiality. 

Physicians reviewed data received from the app and sensor transmissions each weekday and could intervene in their patient’s care if necessary. Patients in both the CYCORE group and the usual-care group had weekly in-person physician visits.

At the start of radiation therapy, the study participants completed a 28-item MD Anderson Symptom Inventory (MDASI) survey regarding their health, including symptoms such as pain, fatigue, nausea, difficulty swallowing or chewing, skin pain/burning/rash, and problems tasting food, as well as questions about their daily activities.

The study participants completed a similar survey at the end of the radiation therapy (usually 6 to 7 weeks later) and a final survey 6 to 8 weeks after radiation therapy ended. Symptom severity and interference were rated on 0-to-10 scales; lower scores indicated better outcomes.

The researchers found that baseline MDASI mean scores were similar in patients randomized to CYCORE or usual care. Mean scores on the severity of general and head and neck cancer–specific symptoms were lower in the CYCORE vs usual-care group at the completion of radiation therapy (2.92 vs 3.4, = .003; 4.21 vs 4.83, = .009) and at 6 to 8 weeks post–radiotherapy completion (1.69 vs 1.96; = .003; 1.78 vs 2.11, = .009). Mean scores on symptom interference in daily life were similar in both groups across time. 

Commentary

“We believe that good patient adherence plus the fact that this [technology] posed a minimal burden on clinicians to do the monitoring supports the use of systems like CYCORE during intensive treatment periods in cancer care,” said Susan K. Peterson, PhD, Professor in the Department of Behavioral Science at The University of Texas MD Anderson Cancer Center, during the press briefing. “Using sensor-mobile technology to monitor patients during critical peak treatments of outpatient care can provide a timely source of information for clinical decision-making and may ultimately improve quality of life and health outcomes. We believe this is the first and largest study of its kind in head and neck cancer, and our next steps would be to explore ways to implement this as part of clinical care, including in community cancer centers, where most patients receive their care.”

“This study adds to a growing body of knowledge showing the value of integrating patient-reported outcomes into routine oncology practice for symptom monitoring that a wide variety of people can participate in,” commented ASCO President Bruce E. Johnson, MD, FASCO, during the press briefing. “We think this will increasingly become a way of getting timely information for both recognizing and treating symptoms, which will ultimately lead to reduced complications. This is particularly important in head and neck cancer, where people commonly have a lot of side effects….”

Funding for this study was provided by the National Institutes of Health. Renata Ferrarotto, MD, reported a consulting or advisory role with Ayala Pharmaceuticals and has received (institutional) research funding from OncoMed, G1 Therapeutics, AstraZeneca/MedImmune, EMD Serono, Genentech/Roche, and Merck Serono. The other study authors reported no conflicts of interest.

 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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