DAHANCA PRO: Patient-Reported Outcomes in Head and Neck Cancer
Study Details
Study Description
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:
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Quality of life
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Objective toxicity score (DAHANCA)
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Opioid treatment
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Tube feeding
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Weight loss
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Hospitalization
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Compliance to treatment
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
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.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Control group First phase. 97 participants. This group will continue standard procedure regarding side effect registration and handling. When the 97 patients have been included and have finished their radiotherapy the second phase will be initiated. |
|
| Experimental: PRO group Second phase. 194 participants. This group will be assigned to the intervention which is weekly electronic Patient-Reported Outcomes. Patients report the symptoms (PRO) on a tablet before each weekly control visit. The clinician will use the patients PRO answers as part of the consultation. The PRO symptoms consist of head and neck relevant items fra PRO-CTCAE™ (Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events) and EORTC (European Organisation for Research and Treatment of Cancer) item library. |
Other: Electronic Patient-Reported Outcome
Weekly reporting of patient-reported outcomes on a tablet for closer contact between patient and clinic during radiotherapy.
Other Names:
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Outcome Measures
Primary Outcome Measures
- 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 Outcome Measures
- 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
Eligibility Criteria
Criteria
Inclusion Criteria:
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Primary or post-operative curative radiotherapy (photons) plus/minus concomitant Cisplatinum for squamous-cell carcinoma of the head and neck (HNSCC)
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No serious cognitive deficits
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Read and understand Danish
Exclusion Criteria:
•Prior radiotherapy in the same area (head and neck)
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Aalborg University Hospital | Aalborg | Denmark | ||
| 2 | Herlev Hospital | Copenhagen | Denmark | ||
| 3 | Rigshoapitalet | Copenhagen | Denmark | ||
| 4 | Zealand Hospital | Næstved | Denmark | ||
| 5 | Odense University Hospital | Odense | Denmark | ||
| 6 | Aarhus University Hospital | Århus | Denmark |
Sponsors and Collaborators
- Rigshospitalet, Denmark
- 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
Investigators
- Principal Investigator: Cecilie Holländer-Mieirtz, MD, Rigshospitalet, Denmark
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
None provided.- DAHANCA PRO