Sensor and mobile technology may be able to monitor head and neck cancer patients’ symptoms and related outcomes during critical periods of outpatient cancer treatment, potentially improving outcomes, according to new data to be presented at the 2018 ASCO Annual Meeting, being held June 1–5 in Chicago. Results from a randomized clinical trial of 357 patients receiving radiation for head and neck cancer showed that new communications technology could provide timely information to facilitate rapid clinical decision making about care.
“We believe this is the first and largest study of its kind in head and neck cancer,” lead study author Susan K. Peterson, PhD, a professor in the Department of Behavioral Science, at the University of Texas MD Anderson Cancer Center in Houston, said at a news briefing on May 16, 2018. Peterson said these findings suggest newer technologies can be integrated into cancer care relatively easily and improve patient outcomes without interfering too much in patients' daily life.
The new approach included a Bluetooth-enabled weight scale, Bluetooth-enabled blood pressure cuff, and mobile tablet with a symptom-tracking app. Patients who used the technology had lower symptom severity than participants who had standard weekly visits with their physicians. In addition, improved tracking enabled clinicians to detect concerning symptoms early and respond more rapidly compared with usual care.
The trial used a technology system called CYCORE (Cyberinfrastructure for Comparative Effectiveness Research). Patients were randomly assigned to CYCORE (n =169) or usual care (n = 188). The mean age for the entire cohort was 60 years (range, 25–86). In the study cohort, 79% of patients were male, 85% were white, and 54% had completed college.
Patients in the CYCORE group used mobile tablets with proprietary Wi-Fi. An in-home wide area network (WAN) hub/router transmitted their sensor readouts, and a mobile app transmitted their symptom data through a back-end cyber-infrastructure to secure firewall-protected computers at the medical center.
For the CYCORE group, physicians reviewed data from the app and sensor transmissions remotely each weekday, and could intervene in a person’s care if necessary. Both CYCORE and usual care participants had weekly in-person doctor visits. The researchers found there were no differences in self-reported health severity scores between the CYCORE participants and those who received routine care at the start of the trial. Symptom severity was scored on a scale of 0–10, with 10 being the highest level of symptom severity.
After completion of radiation therapy, the CYCORE participants had lower mean scores for general symptoms vs usual-care participants (2.9 vs 3.4), as well as lower mean scores for symptoms specific to head and neck cancer (4.2 vs 4.8).
“At the end of treatment, patients in the CYCORE group reported fewer symptoms,” said Peterson. “Symptoms can affect the patient’s ability to tolerate treatment.”
Six to 8 weeks after completion of therapy, CYCORE participants had a mean score of 1.6, compared with a mean score of 1.9 for usual-care participants, based on overall health. Both groups had slightly higher severity scores for specific head and neck symptoms (1.7 vs 2.1). Scores reflecting how various symptoms interfered with activities of daily living were about the same across both groups throughout the duration of survey reporting. The researchers next plan to study how long the benefit of a CYCORE intervention could persist, and they hope to implement their findings in nonacademic cancer treatment settings.
ASCO President Bruce E. Johnson, MD, said he hoped these types of technologies will be broadly available to patients soon. He said the current study demonstrates the power of leveraging smart technology to improve cancer care. “These tools helped simplify care for both patients and their care providers by enabling emerging side effects to be identified and addressed quickly and efficiently to ease the burden of treatment,” said Dr. Johnson.