Patient-reported symptoms and stepwise symptom management in patients on epidermal growth factor inhibitors: A retrospective, descriptive cohort study
Corresponding Author
J.J. Koldenhof RN, MSc
Nurse Practitioner in Training
Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
Correspondence
Josephine J. Koldenhof, Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands.
Email: [email protected]
Search for more papers by this authorM.H.G. Langenberg MD, PhD
Medical Oncologist
Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorP.O. Witteveen MD, PhD
Professor of Medical Oncology
Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorS.C.C.M. Teunissen RN, PhD
Professor in Hospice Care/Palliative Care
Department of Primary Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorCorresponding Author
J.J. Koldenhof RN, MSc
Nurse Practitioner in Training
Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
Correspondence
Josephine J. Koldenhof, Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands.
Email: [email protected]
Search for more papers by this authorM.H.G. Langenberg MD, PhD
Medical Oncologist
Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorP.O. Witteveen MD, PhD
Professor of Medical Oncology
Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorS.C.C.M. Teunissen RN, PhD
Professor in Hospice Care/Palliative Care
Department of Primary Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
Search for more papers by this authorAbstract
Adverse events (AEs) of epidermal growth factor inhibitors (EGFRi) influence well-being with a risk to dose modifications (DMs). Hereby, clinical benefit of treatment might be affected. This retrospective cohort study was set up to gain insight into the suitability and added value of a patient-reported outcome measurement tool (PROM), together with a stepwise intervention management plan for EGFRi-related AEs in daily practice.
The primary objective was to gain insight into total treatment duration and DMs, and the secondary objective to gain insight into patient-reported symptoms and well-being as well as healthcare professional-reported AEs.
Sixty-eight patients on cetuximab and 19 on panitumumab treatment were included for analysis; 69% had squamous cell carcinoma of head and neck (SCCHN) and 26% metastatic colorectal carcinoma.
DMs due to AEs occurred in 39% of the patients and dose discontinuations in 22%. Especially anorexia, dysphagia, oral pain and skin changes led to a decreased well-being.
In patients on EGFRi, application of PROMs together with a stepwise symptom management plan enhances early recognition of symptom burden, pro-active symptom management and effect evaluation of interventions performed whereby well-being recovers. Since only SCCHN patients discontinued treatment due to AEs, patient-centred care focused on radiotherapy-related AEs, creates opportunities for amelioration.
CONFLICT OF INTEREST
The authors have no conflict of interests to declare. The authors have full control of all primary data and we agree to allow the journal to review our data if requested.
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