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Symptom Management for Patients with Advanced Gastrointestinal Cancer Undergoing Chemotherapy Based on Patient-Reported Outcomes Obtained from Electronic Platforms


 Purpose: The electronic patient-reported outcome (ePRO) system plays an important role in routine cancer treatment, but information on its use to assess and monitor symptoms and quality of life (QoL) in advanced gastrointestinal cancer patients in China is limited.Methods: Sixty patients with advanced gastrointestinal cancer at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled. They completed the ePRO questionnaires on a computer to provide nutrition, appetite, psychology, and QoL data at the beginning of cancer treatment. The nurses followed up the assessment results and provided feed-back to the clinicians, then, doctors addressed the symptoms according to the assessment results. The primary outcome was change in nutritional status. Secondary endpoints included appetite, psychological status and QoL.Results: There were 60 patients, 54 completed the follow-up. At the fourth visit, the Nutrition Risk Screening 2002 (NRS2002) and Patient-Generated Subjective Global Assessment (PG-SGA) scale scores improved significantly (p < 0.05). More than 70% of PG-SGA (73.08%), Functional Assessment of Anorexia/Cachexia Therapy Anorexia/Cachexia Subscale (FAACT-A/CS) (76.92%), Psychological Distress Thermometer (DT) (75.00%) and EuroQol Five Dimensions Questionnaire (EQ-5D) (78.84%) scores improved or remained stable. The results of the Generalized Linear Model (GLM) analysis showed that nutritional status, psychological status and QoL gradually improved with symptom management (p < 0.05).Conclusion: This symptom management closed-loop model can effectively manage the relevant symptoms of patients and improve QoL.Clinical trial information ChiCTR2100048290, date of registration July 5, 2021.