Shilo Lefresne1, Robert Olson2, Rosemary Cashman3, Paula Kostuik3, Wei Ning Jiang4, Karen Levy3, Michael R Mckenzie3, Ann Hulstyn3, Mitchell Liu3, Jonn Wu3, Eric Berthelet3. 1. Radiation Therapy Program, Vancouver Cancer Centre, BC Cancer Agency, 600 W 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada. Electronic address: slefresne@bccancer.bc.ca. 2. Radiation Therapy Program, Center for the North, BC Cancer Agency, 1215 Lethbridge Street, Prince George, British Columbia, V2 M 7E9, Canada. 3. Radiation Therapy Program, Vancouver Cancer Centre, BC Cancer Agency, 600 W 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada. 4. Radiation Therapy Program, Vancouver Cancer Centre, BC Cancer Agency, 600 W 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada; Faculty of Medicine, University of British Columbia, 2329 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada.
Abstract
INTRODUCTION: The Vancouver Rapid Access (VARA) clinic was designed to provide palliative radiotherapy and holistic care to patients with incurable lung cancer. Analysis of the pilot phase demonstrated improved radiotherapy wait-times and access to supportive services compared to standard practice. This study aims to prospectively assess the impact of the clinic on patient reported symptoms and quality of life. MATERIALS AND METHODS: Patient assessments are completed at baseline and by a telephone follow up four-weeks later using Likert scales adapted from the Edmonton Symptom Assessment System (scale 0-10) and European Organization for Research and Treatment of Cancer questionnaires (scale 1-4). Patient reported outcomes at follow-up are compared to baseline using wilcoxon signed-rank test for categorical variables and paired sample t-test for continuous variables. RESULTS: Baseline data was collected on 125 patients, 109 received palliative radiotherapy (87%). At the 4 week follow up, 22 patients had died. Seventy-one of the remaining 103 patients completed the follow-up questionnaire, resulting in a 69% response rate among survivors. The mean patient reported overall health score, improved from 4.8 to 6.1 (p<0.01). All respiratory symptoms except chest pain (p=0.06) were associated with a statistically significant improvement after the clinic, whereas all respiratory symptoms improved post radiotherapy. Mean bone pain scores decreased from 5.5 to 2.7 (p<0.01). Assessment of symptoms secondary to brain metastases is limited by small patient numbers. CONCLUSION: The VARA clinic provides timely access to palliative radiotherapy and supportive services resulting in improved patient reported outcomes. Despite a high symptom and disease burden, patients report improved overall health and palliation of respiratory symptoms and bony pain. The studies completed on the VARA clinic to date, continue to support its value in our center.
INTRODUCTION: The Vancouver Rapid Access (VARA) clinic was designed to provide palliative radiotherapy and holistic care to patients with incurable lung cancer. Analysis of the pilot phase demonstrated improved radiotherapy wait-times and access to supportive services compared to standard practice. This study aims to prospectively assess the impact of the clinic on patient reported symptoms and quality of life. MATERIALS AND METHODS:Patient assessments are completed at baseline and by a telephone follow up four-weeks later using Likert scales adapted from the Edmonton Symptom Assessment System (scale 0-10) and European Organization for Research and Treatment of Cancer questionnaires (scale 1-4). Patient reported outcomes at follow-up are compared to baseline using wilcoxon signed-rank test for categorical variables and paired sample t-test for continuous variables. RESULTS: Baseline data was collected on 125 patients, 109 received palliative radiotherapy (87%). At the 4 week follow up, 22 patients had died. Seventy-one of the remaining 103 patients completed the follow-up questionnaire, resulting in a 69% response rate among survivors. The mean patient reported overall health score, improved from 4.8 to 6.1 (p<0.01). All respiratory symptoms except chest pain (p=0.06) were associated with a statistically significant improvement after the clinic, whereas all respiratory symptoms improved post radiotherapy. Mean bone pain scores decreased from 5.5 to 2.7 (p<0.01). Assessment of symptoms secondary to brain metastases is limited by small patient numbers. CONCLUSION: The VARA clinic provides timely access to palliative radiotherapy and supportive services resulting in improved patient reported outcomes. Despite a high symptom and disease burden, patients report improved overall health and palliation of respiratory symptoms and bony pain. The studies completed on the VARA clinic to date, continue to support its value in our center.
Authors: Monica L L Mullin; Audrey Tran; Breanne Golemiec; Christopher J L Stone; Christine Noseworthy; Nicole O'Callaghan; Christopher M Parker; Geneviève C Digby Journal: JCO Oncol Pract Date: 2020-07-08
Authors: Jordan Hill; Mohannad Alhumaid; Sunita Ghosh; Alexander Le; Sharon M Watanabe; Alysa Fairchild Journal: Support Care Cancer Date: 2022-07-22 Impact factor: 3.359