Follow-up for human papillomavirus-related oropharynx cancer concentrated on unequal symptom change (FOCUS): Prospective patient-reported outcome collection.

Autor: Edwards DM; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA., Gharzai LA; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.; Department of Radiation Oncology, Northwestern University, Chicago, Illinois, USA., Wang W; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA., Mayo C; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA., Suresh K; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA., Schipper M; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA., Evans JR; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA., Malloy K; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Chinn SB; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Prince M; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Spector M; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Shuman A; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Stucken C; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Swiecicki PL; Department of Medicine, Hematology-Oncology, University of Michigan, Ann Arbor, Michigan, USA., Worden F; Department of Medicine, Hematology-Oncology, University of Michigan, Ann Arbor, Michigan, USA., Jarema J; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Henderson C; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA., Kovach A; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA., Brenner C; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA., Shah JL; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA., Mierzwa ML; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA., Casper K; Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Nov; Vol. 46 (11), pp. 2687-2698. Date of Electronic Publication: 2024 Apr 29.
DOI: 10.1002/hed.27778
Abstrakt: Background: Post-treatment surveillance recommendations for oropharyngeal cancer do not vary with p16 status despite the differences in outcomes. The optimal algorithm personalizing follow-up for these patients remains undefined. Here, we evaluate the feasibility and utility of incorporating electronic patient-reported outcomes (ePROs) and circulating tumor DNA (ctDNA) into routine surveillance for patients treated for p16+ oropharynx cancer.
Methods: A prospective registry was developed in which ePROs and ctDNA were incorporated into routine surveillance among patients with oropharynx cancer. ePROs were emailed monthly for 1 year and blood HPV ctDNA testing was performed every 3-6 months. The primary objective was to assess patient compliance with ePRO-based surveillance with adequate compliance defined as ≥85% of patients completing monthly ePROs. Sensitivity, specificity, and positive/negative predictive values to detect recurrence were calculated for ePROs, HPV ctDNA, or the combination.
Results: Of 122 patients who initially expressed interest, 76 completed the electronic consent process and 44/76 (58%) were compliant with monthly surveys over 1 year; thus adequate compliance was not achieved. Technical difficulties associated with ePRO receipt through email largely limited participation. Provider feedback was significantly associated with heightened ePRO compliance. One hundred and six patients had ctDNA testing with a mean number of three tests per patient. Sensitivity to detect recurrence was 75% for the combination of ePROs and ctDNA.
Conclusion: Despite lower than anticipated compliance with ePROs, our findings show promise for incorporation of HPV ctDNA into surveillance paradigms for HPV-related oropharynx cancer with suggestions of methods to optimize ePRO formats for personalized surveillance.
(© 2024 The Authors. Head & Neck published by Wiley Periodicals LLC.)
Databáze: MEDLINE
Externí odkaz: