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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 7/2017

01-07-2017 | Original Article

Patient-reported symptoms during radiotherapy

Clinically relevant symptom burden in patients treated with palliative and curative intent

Authors: Dr. Philipp Körner, Katja Ehrmann, Johann Hartmannsgruber, Michaela Metz, Sabrina Steigerwald, Prof. Dr. Michael Flentje, Prof. Dr. Birgitt van Oorschot

Published in: Strahlentherapie und Onkologie | Issue 7/2017

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Abstract

Background

The benefits of patient-reported symptom assessment combined with integrated palliative care are well documented. This study assessed the symptom burden of palliative and curative-intent radiation oncology patients.

Patients and methods

Prior to first consultation and at the end of RT, all adult cancer patients planned to receive fractionated percutaneous radiotherapy (RT) were asked to answer the Edmonton Symptom Assessment Scale (ESAS; nine symptoms from 0 = no symptoms to 10 = worst possible symptoms). Mean values were used for curative vs. palliative and pre–post comparisons, and the clinical relevance was evaluated (symptom values ≥ 4).

Results

Of 163 participating patients, 151 patients (90.9%) completed both surveys (116 curative and 35 palliative patients). Before beginning RT, 88.6% of palliative and 72.3% of curative patients showed at least one clinically relevant symptom. Curative patients most frequently named decreased general wellbeing (38.6%), followed by tiredness (35.0%), anxiety (32.4%), depression (30.0%), pain (26.3%), lack of appetite (23.5%), dyspnea (17.8%), drowsiness (8.0%) and nausea (6.1%). Palliative patients most frequently named decreased general wellbeing (62.8%), followed by pain (62.8%), tiredness (60.0%), lack of appetite (40.0%), anxiety (38.0%), depression (33.3%), dyspnea (28.5%), drowsiness (25.7%) and nausea (14.2%). At the end of RT, the proportion of curative and palliative patients with a clinically relevant symptom had increased significantly to 79.8 and 91.4%, respectively; whereas the proportion of patients reporting clinically relevant pain had decreased significantly (42.8 vs. 62.8%, respectively). Palliative patients had significantly increased tiredness. Curative patients reported significant increases in pain, tiredness, nausea, drowsiness, lack of appetite and restrictions in general wellbeing.

Conclusion

Assessment of patient-reported symptoms was successfully realized in radiation oncology routine. Overall, both groups showed a high symptom burden. The results prove the need of systematic symptom assessment and programs for early integrated supportive and palliative care in radiation oncology.
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Metadata
Title
Patient-reported symptoms during radiotherapy
Clinically relevant symptom burden in patients treated with palliative and curative intent
Authors
Dr. Philipp Körner
Katja Ehrmann
Johann Hartmannsgruber
Michaela Metz
Sabrina Steigerwald
Prof. Dr. Michael Flentje
Prof. Dr. Birgitt van Oorschot
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 7/2017
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-017-1146-5

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