PROMIS scores of patients undergoing neoadjuvant and adjuvant radiation therapy for surgically excised soft tissue sarcoma

Moon, Tae-Gun; Furdock, Ryan; Rhea, Lee; Pergolotti, Mackenzi; Cipriano, Cara A.; Spraker, Matthew B.

doi:10.1016/j.ctro.2021.08.008

Cited by 6 publications

(17 citation statements)

References 45 publications

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“…Our results are consistent with several prior studies showing worse physical outcomes in AYAs undergoing cancer treatment as compared to the general population 17,19–21 . For patients actively receiving RT, worse physical health could be due to the loss of a normal exercise routine, side effects from RT, or from greater radiation dose distributions to organs that affect physical activity, such as the heart or brain 22–25 . In addition to the burdensome radiation treatment process, impaired physical health may lead to development of comorbidities, work disruptions, or decreased social engagement, which are all significant contributions to morbidity for AYAs 26–29 .…”

Section: Discussionsupporting

confidence: 90%

Patient‐reported quality of life in adolescents and young adults with cancer who received radiation therapy

et al. 2023

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Background Radiation therapy (RT) is a common treatment for adolescents and young adults (AYAs, 15–39 years old) with cancer; however, it may cause toxicities that affect health‐related quality‐of‐life (HRQOL). Thus, we assessed HRQOL in AYAs before, during, and after RT. Methods We identified 265 AYAs who completed HRQOL PROMIS® surveys before (n = 87), during (n = 84), or after (n = 94) RT. Higher PROMIS® score represents more of the concept. Mean scores were compared to the general US population and minimally important differences (MIDs) were used to evaluate the impact of cancer on HRQOL. Linear regression modeling was used to evaluate the effect of clinical and demographic factors on PROMIS scores. Results Median [IQR] age was 26 [20–31] years. Cancer types varied; most had sarcoma (26%) or CNS malignancy (23%). Compared to the general US population, the before RT cohort had worse anxiety (mean score 55.2 vs. 50, MID 3, p < 0.001) and the during RT cohort had worse global physical health (mean score 44.9 vs. 50, MID 5, p < 0.001). In the during RT cohort, patients with regional/distant disease had significantly worse pain (B = 15.94, p < 0.01) and fatigue (B = 14.20, p = 0.01) than patients with localized disease. In the after RT cohort, adolescents (15–18 years) and young adults (26–39 years) had worse global physical health (B = ‐6.87, p < 0.01, and B = ‐7.87, p < 0.01, respectively) and global mental health (B = ‐6.74, p < 0.01, and B = ‐5.67, p = 0.01, respectively) than emerging adults (19–25 years). Conclusions AYAs with cancer receiving RT experience impairments in various domains of HRQOL. Advanced cancer stage may contribute to poorer short‐term HRQOL and developmental stage may contribute to differing long‐term HRQOL.

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Section: Discussionsupporting

confidence: 90%

Patient‐reported quality of life in adolescents and young adults with cancer who received radiation therapy

et al. 2023

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“…For example, Chen et al demonstrated that PROMIS scores significantly improved in patients undergoing ACL reconstruction and have the ability to predict postoperative outcomes [ 13 ]. However, the ability of PROMIS to detect differences in patient-reported outcomes in the setting of adult sarcoma has only recently been examined in a small number of studies [ 15 - 16 ]. Additionally, no studies have been performed comparing pre- and postsurgical PROMIS scores in patients with benign versus malignant soft tissue tumors (STTs).…”

Section: Introductionmentioning

confidence: 99%

Pre- and Post-Operative Patient-Reported Outcome Measurement Information System Scores in Patients Treated for Benign Versus Malignant Soft Tissue Tumors

Dalton¹,

Furdock²,

Cluts³

et al. 2022

Cureus

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Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) assesses multiple aspects of patient well-being but has not been thoroughly studied amongst orthopedic oncology patients. Questions/purposes: How do preoperative/early postoperative PROMIS scores compare in patients with benign versus malignant soft tissue tumors (STTs) for (1) physical function, (2) pain interference, and (3) depression? Are the differences clinically relevant? What other patient/tumor factors impact PROMIS? Methods: This retrospective cohort study included 314 STT patients who underwent resection of a benign (n = 187) or malignant (n = 127) STT over a period of 4.25 years at a single institution. PROMIS physical function, pain interference, and depression scores were collected preoperatively and at two and six weeks postoperatively. Scores for each time point were compared between groups and to preoperative baselines. Backward-stepwise linear mixed-effects models were produced to identify independent predictors of change in each PROMIS domain. The minimal clinically important difference (MCID) was 4 points. Results: The malignant cohort, but not the benign cohort, demonstrated clinically relevant worsening of physical function postoperatively. Malignant diagnosis (△ = −4.4, p < 0.001) and lower extremity tumors (△ = −4.5, p < 0.001) were identified as clinically relevant, independent predictors of worse physical function at all time points. No predictors of clinically relevant changes in pain interference or depression scores, including malignancy, were identified. Conclusions: In STT patients, malignancy and lower extremity STT location are associated with clinically relevant worsening in physical function but do not significantly impact pain interference or depression in the early postoperative period. These findings may help establish the utility of PROMIS in an orthopedic oncology population.

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“…It should be noted that T-scores are IRT-based scores. Because studies [25][26][27] have reported reliable change in PROMIS using RCI with CTT-based standard errors despite using IRT-based scores, we used the same approach when we applied the CTT method.…”

Section: Discussionmentioning

confidence: 99%

Identifying meaningful change on PROMIS short forms in cancer patients: a comparison of item response theory and classic test theory frameworks

et al. 2022

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Background This study compares classical test theory and item response theory frameworks to determine reliable change. Reliable change followed by anchoring to the change in categorically distinct responses on a criterion measure is a useful method to detect meaningful change on a target measure. Methods Adult cancer patients were recruited from five cancer centers. Baseline and follow-up assessments at 6 weeks were administered. We investigated short forms derived from PROMIS® item banks on anxiety, depression, fatigue, pain intensity, pain interference, and sleep disturbance. We detected reliable change using reliable change index (RCI). We derived the T-scores corresponding to the RCI calculated under IRT and CTT frameworks using PROMIS® short forms. For changes that were reliable, meaningful change was identified using patient-reported change in PRO-CTCAE by at least one level. For both CTT and IRT approaches, we applied one-sided tests to detect reliable improvement or worsening using RCI. We compared the percentages of patients with reliable change and reliable/meaningful change. Results The amount of change in T score corresponding to RCICTT of 1.65 ranged from 5.1 to 9.2 depending on domains. The amount of change corresponding to RCIIRT of 1.65 varied across the score range, and the minimum change ranged from 3.0 to 8.2 depending on domains. Across domains, the RCICTT and RCIIRT classified 80% to 98% of the patients consistently. When there was disagreement, the RCIIRT tended to identify more patients as having reliably changed compared to RCICTT if scores at both timepoints were in the range of 43 to 78 in anxiety, 45 to 70 in depression, 38 to 80 in fatigue, 35 to 78 in sleep disturbance, and 48 to 74 in pain interference, due to smaller standard errors in these ranges using the IRT method. The CTT method found more changes compared to IRT for the pain intensity domain that was shorter in length. Using RCICTT, 22% to 66% had reliable change in either direction depending on domains, and among these patients, 62% to 83% had meaningful change. Using RCIIRT, 37% to 68% had reliable change in either direction, and among these patients, 62% to 81% had meaningful change. Conclusion Applying the two-step criteria demonstrated in this study, we determined how much change is needed to declare reliable change at different levels of baseline scores. We offer reference values for percentage of patients who meaningfully change for investigators using the PROMIS instruments in oncology.

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PROMIS scores of patients undergoing neoadjuvant and adjuvant radiation therapy for surgically excised soft tissue sarcoma

Cited by 6 publications

References 45 publications

Patient‐reported quality of life in adolescents and young adults with cancer who received radiation therapy

Patient‐reported quality of life in adolescents and young adults with cancer who received radiation therapy

Pre- and Post-Operative Patient-Reported Outcome Measurement Information System Scores in Patients Treated for Benign Versus Malignant Soft Tissue Tumors

Identifying meaningful change on PROMIS short forms in cancer patients: a comparison of item response theory and classic test theory frameworks

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