ESTRO 2021 Abstract Book

S549

ESTRO 2021

organization and the possibility to be dedicated only to the planning tasks. Regarding our results, it could be feasible to implement partially remote work on a regular basis while keeping, in part, on-site work in order to maintain personal contact with colleagues and contribute to the staff satisfaction.

Symposium: The use of telehealth in radiotherapy

SP-0695 Experience of using telehealth for individualised supportive care and follow-up in radiotherapy P.K. Møller 1 , H. Pappot 2 , U. Bernchou 3 , T. Schytte 1 , K.B. Dieperink 1 1 Odense University Hospital, Department of Oncology, Odense, Denmark; 2 Rigshospitalet, Department of Oncology, Copenhagen, Denmark; 3 Odense University Hospital, Laboratory of Radiation Physics, Odense, Denmark

Abstract Text Purpose/Objective

Patients with cancer in the pelvic area experience individual ranges of symptoms during external beam radiotherapy (RT). Real-time monitoring of symptoms reported directly by the patients, patient-reported outcomes (PRO), is a way of ensuring these symptoms are detected and it allows for timely patient-centered care. Thus, the purpose of using telehealth for symptom monitoring during the course of radiotherapy is to ensure treatment toxicity is identified and addressed. In addition, the use of PRO for digital symptom monitoring adds a patient perspective to the evaluation of treatment toxicity when new technology like online MR-guided RT (MRgRT) is introduced. Before applying electronic PRO (ePRO) with real-time feedback in RT the purpose of implementing PRO must be thoroughly considered and a streamlined implementation process undertaken. The objective of the presented study was to conduct a systematic implementation of longitudinal ePRO in pelvic RT using an online eHealth system. A process that contained a systematic selection of items to construct a simple item set and a content validation of the selected items. In addition, a pilot testing of usability and patient acceptance to ensure sustainability in the implementation before initiating a prospective, longitudinal study evaluating online MRgRT based on ePRO. Material/Methods A pilot study in two phases was conducted. The first phase contained a literature review to identify relevant acute symptomatic adverse events (AEs) for patients with pelvic cancer treated with RT with a curative intent. These symptoms were complimented by a chart audit of acute treatment toxicity reported for all pelvic patients treated with online MRgRT at the 1.5 T Unity MR-linac with a curative intent. To ensure all identified acute symptomatic AEs were covered items were selected from the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) library and the European Organisation for Research and Treatment of Cancer (EORTC) Item Library. To validate the content of the initial item set in the second phase, the items were applied in a prospective cohort of patients with prostate, cervical, rectum and bladder cancer referred for RT with a curative intent. The patients reported symptoms weekly during CBCT-guided RT or online MRgRT and four weeks following. Follow-up reports were collected at week eight, twelve and twenty four after the course of radiotherapy. The patients were to use their own device at home to report symptoms in a patient pathway app/webside, My Hospital . Data was directly transferred to the electronic health record (EHR), however no clinician feedback was provided in the pilot study. The criteria for symptoms in the final pelvic item set was a cut-off of > 20% of the patients in all patient groups having reported the symptom. To evaluate content validity, design, ePRO usability and patient acceptance the Patient Feedback Form was used together with semi-structured patient interviews. A prospective longitudinal study with the aim of capturing the acute toxicity of online MRgRT and investigate a model of care with real-time feedback based on ePRO was subsequently initiated. Results The first phase resulted in 18 acute symptomatic AEs being selected for an initial item set . A prospective pilot study was conducted with 41 patients with cancer; 32 prostate cancer, eight cervical cancer and one bladder cancer. No rectal cancer patients were eligible for inclusion. The only patient with bladder cancer was excluded from the analysis, thus 40 patients were included (median age 68 (36-76)). All 18 acute AEs were reported by the patients. However, vomiting was reported below the 20% cut-off suggesting a pelvic generic item set with 17 symptomatic AEs. For both prostate and cervical cancer patients there was a need for diagnosis-specific additions. Compliance was high with 85% of the patients responding to >80% of the weekly questionnaires and the patient burden low as all patients (100%) found the PRO item set useful and easy to complete and the time spent appropriate (97%). Since no real-time clinician feedback was provided, patients experienced their responses not being used (83%). This was also mentioned by the patients being interviewed (n=14). Conclusion A PRO item set for prostate and cervical cancer patients was developed assessing the 17 most common symptomatic AEs related to pelvic RT including online MRgRT. The content of the item set was validated in a pilot study and a need for diagnosis-specific additions to the generic items were identified. Using a simple item set for weekly reporting on their own device ensured a low patient burden and a high adherence rate. Real-time clinician feedback was requested, thus being implemented in the ongoing prospective longitudinal study with the aim of evaluating acute PRO to online MRgRT.

SP-0696 Using an app to monitor patients' side effects: The Sympro Trial E. Veldhuijzen The Netherlands