Basch Ethan, Dueck Amylou C, Rogak Lauren J, Mitchell Sandra A, Minasian Lori M, Denicoff Andrea M, Wind Jennifer K, Shaw Mary C, Heon Narre, Shi Qian, Ginos Brenda, Nelson Garth D, Meyers Jeffrey P, Chang George J, Mamon Harvey J, Weiser Martin R, Kolevska Tatjana, Reeve Bryce B, Bruner Deborah Watkins, Schrag Deborah
Ethan Basch, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill; Bryce B. Reeve, Duke Cancer Institute, Duke University Medical Center, Durham, NC; Ethan Basch, Lauren J. Rogak, Mary C. Shaw, Narre Heon, and Martin R. Weiser, Memorial Sloan Kettering Cancer Center, New York, NY; Amylou C. Dueck and Brenda Ginos, Alliance Statistics and Data Center, Mayo Clinic, Scottsdale, AZ; Sandra A. Mitchell, Lori M. Minasian, and Andrea M. Denicoff, National Cancer Institute, Rockville, MD; Jennifer K. Wind, Harvey J. Mamon, and Deborah Schrag, Dana-Farber/Partners CancerCare, Boston, MA; Qian Shi, Garth D. Nelson, and Jeffrey P. Meyers, Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; George J. Chang, University of Texas MD Anderson Cancer Center, Houston, TX; Tatjana Kolevska, Kaiser Permanente Vallejo Medical Center, Vallejo, CA; and Deborah Watkins Bruner, Emory University, Atlanta, GA.
J Clin Oncol. 2018 Sep 11;36(31):JCO2018788620. doi: 10.1200/JCO.2018.78.8620.
Purpose The US National Cancer Institute (NCI) Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) was developed to enable patient reporting of symptomatic adverse events in oncology clinical research. This study was designed to assess the feasibility and resource requirements associated with implementing PRO-CTCAE in a multicenter trial. Methods Patients with locally advanced rectal cancer enrolled in the National Cancer Institute-sponsored North Central Cancer Treatment Group (Alliance) Preoperative Radiation or Selective Preoperative Radiation and Evaluation before Chemotherapy and Total Mesorectal Excision trial were asked to self-report 30 PRO-CTCAE items weekly from home during preoperative therapy, and every 6 months after surgery, via either the Web or an automated telephone system. If participants did not self-report within 3 days, a central coordinator called them to complete the items. Compliance was defined as the proportion of participants who completed PRO-CTCAE assessments at expected time points. Results The prespecified PRO-CTCAE analysis was conducted after the 500th patient completed the 6-month follow-up (median age, 56 years; 33% female; 12% nonwhite; 43% high school education or less; 5% Spanish speaking), across 165 sites. PRO-CTCAE was reported by participants at 4,491 of 4,882 expected preoperative time points (92.0% compliance), of which 3,771 (77.2%) were self-reported by participants and 720 (14.7%) were collected via central coordinator backup. Compliance at 6-month post-treatment follow-up was 333 of 468 (71.2%), with 122 (26.1%) via backup. Site research associates spent a median of 15 minutes on PRO-CTCAE work for each patient visit. Work by a central coordinator required a 50% time commitment. Conclusion Home-based reporting of PRO-CTCAE in a multicenter trial is feasible, with high patient compliance and low site administrative requirements. PRO-CTCAE data capture is improved through centralized backup calls.
目的 美国国立癌症研究所(NCI)患者报告的不良事件通用术语标准(PRO-CTCAE)版本旨在使患者能够在肿瘤临床研究中报告有症状的不良事件。本研究旨在评估在多中心试验中实施PRO-CTCAE的可行性和资源需求。方法 参加国立癌症研究所赞助的北中部癌症治疗组(联盟)术前放疗或选择性术前放疗及化疗和全直肠系膜切除术前评估试验的局部晚期直肠癌患者,被要求在术前治疗期间每周在家中通过网络或自动电话系统自行报告30项PRO-CTCAE项目,术后每6个月报告一次。如果参与者在3天内未自行报告,中央协调员会打电话给他们完成这些项目。依从性定义为在预期时间点完成PRO-CTCAE评估的参与者比例。结果 在第500名患者完成6个月随访后(中位年龄56岁;33%为女性;12%为非白人;43%为高中及以下学历;5%说西班牙语),在165个地点进行了预先指定的PRO-CTCAE分析。在4882个预期的术前时间点中,参与者报告了4491个PRO-CTCAE项目(依从性为92.0%),其中3771个(77.2%)由参与者自行报告,720个(14.7%)通过中央协调员备份收集。治疗后6个月随访时的依从性为468个中的333个(71.2%),其中122个(26.1%)通过备份获得。每个患者访视时,现场研究助理在PRO-CTCAE工作上花费的中位数时间为15分钟。中央协调员的工作需要投入50%的时间。结论 在多中心试验中基于家庭报告PRO-CTCAE是可行的,患者依从性高,现场管理要求低。通过集中备份电话可改善PRO-CTCAE数据采集。