Abstract 1721P
Background
The collaboration between the SCT and the MTB for patients with advanced cancer has been evolving at the IORS. The goal of the study was to assess symptom burden in the referred patients and investigate its relationship with the MTB treatment decision.
Methods
Patients with advanced cancer were referred from the MTB with a treatment decision either to deliver anticancer treatment (ACT) or to provide active symptom control (ASC). Upon admission, the SCT assessed 6 physical symptoms, depression, anxiety and overall well-being reported by patients (PROs) using the Edmonton Symptom Assessment System revised (ESAS-r). The relationship between the individual symptom/overall well-being score (0-10, higher means worse) as well as the composite ESAS-physical and ESAS-total score with the MTB treatment decision was analysed.
Results
A total of 136 patients were referred since Nov 2018 (median age 63; range 19-86). The most common cancer type was GI followed by GU and LC. Pain (128 pts; 94.1%), impaired well-being (122; 89.7%) and fatigue (106; 77.94%) were the most frequent triggers for MTB`s referral. There was no association between patients’ symptom burden (ESAS-total and physical) and the MTB treatment decision. The reported mean intensities of pain (7.66±1.82), fatigue (6.32±2.21) and impaired well-being (6.4±1.95) were high, although not associated with the MTB treatment decision. Table: 1721P
The relationship between reported symptom burden (PROs) and MTB treatment decision
| Symptom burden (ESAS-r) | Total N=136 | MTB decision | Wilcoxon rank sum test (p-value) | |
| ACT N=76 | ASC N=60 | |||
| ESAS total1 Mean (SD) Median (Range) | 33.6 (14.5) 33 (2 - 73) | 32.9 (13.8) 31 (2 - 73) | 34.6 (15.4) 35 (4 - 65) | p=0.533 |
| ESAS physical2 Without score With score Mean (SD) Median (Range) | 1 (0.74%) 135 (99.2%) 20.76 (9.5) 20 (2 - 48) | 1/76 (1.3%) 75/76 (98.6%) 19.85 (9.42) 19 (2 - 48) | - 60/60 (100%) 21.88 (9.65) 21.5 (4 - 42) | p=0.240 |
| Pain3 Without pain With pain Mean (SD) Median (Range) | 8 (5.8%) 128 (94.1%) 7.66 (1.82) 8 (2 - 10) | 4/76 (5.2%) 72/76 (94.7%) 7.68 (1.7) 8 (2 - 10) | 4/60 (6.6%) 56/60 (93.3%) 7.64 (1.93) 8 (3 - 10) | p=0.970 |
1ESAS physical and emotional score plus well-being (0-90) 2ESAS Physical score (0-60) 3Pain score (0-10).
Conclusions
The direct referral of patients by the MTB enabled an early involvement of the SC team and patients to report their symptom burden. Feedback from the SCT to the MTB about patients` symptom burden could be used to support treatment decision making and help triage patients with advanced cancer either for ACT or ASC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.