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Identification of Unmet Survivorship Needs in Primary Lung Cancer Patients: A High Burden for Younger Patients
Poster Viewing Abstracts S715
Volume 90 Number 1S Supplement 2014 Author Disclosure: Z.H. Rana: None. R.L. Hong: None. D. McRae: None. G. Bernstein: None. R. Mordkin: None. A. Joel: None. N. Nasr: None.
3280 What Is the Impact of Survivorship Visits?: Preliminary Analysis From a NCI-Designated Cancer Center Radiation Oncology Program A. Leatherwood, O.V. Sostin, Y. Chen, and C.R. Thomas; Oregon Health and Science University, Portland, OR Purpose/Objective(s): Survivorship care in oncology has been a growing area; however, there is a lack of information regarding its effectiveness. We conducted a pilot study with specific aims to: 1) assess the impact of continuity cancer survivorship visits and survivorship care plans (SCPs) at our department on patient (pt) perception of provider support, 2) personal knowledge on post-treatment concerns, confidence in providers, 3) coordination of care between PCP and oncology providers, and 4) pt comfort level in finding additional information and answers regarding future postcancer health concerns. Materials/Methods: Patients who were definitively treated for a malignancy in our department and were seen by a dedicated survivorship nurse practitioner for a survivorship visit were asked to complete pre-test (5 items) and post-test (6 items) web-based questionnaires, which used Likert scale and were administered on an iPad mini immediately before the visit (pre-test) and at the conclusion of the visit (post-test). Scores of 1-5 were assigned to five levels of agreement (disagree, somewhat disagree, neutral, somewhat agree, and completely agree) respectively, and the responses from pre-test and post-test questionnaires were compared using Wilcoxon signed rank test. Results: Information of 63 pts was collected. The posttest scoring showed significant improvement from pretest scoring for all five questions (p-value from Wilcoxon signed rank test: < .01 for all questions). This suggests that overall, pts found the survivorship visit beneficial, which was also confirmed by mean difference values greater than 0 (range 0.43 to 0.84). While < 50% of all pts have noted an improvement for all five questions, 38 (60.3%) have found it useful in at least one question, and 10 (15.8%) have found it helpful for all questions. Conclusions: The preliminary results of our study suggest that overall, post-cancer treatment survivors feel that the survivorship visit and SCP are helpful. It improves their perception of provider support, personal knowledge on post-cancer treatment concerns, confidence level in the oncology provider team, trust in the coordination of care between PCP and oncology providers, and comfort level in finding additional information and answers regarding future post-cancer treatment concerns. More comprehensive, prospective studies will be needed in the future to confirm these observations. This approach may affirmatively impact survivorship care in clinical radiation therapy. Author Disclosure: A. Leatherwood: None. O.V. Sostin: None. Y. Chen: None. C.R. Thomas: None.
3281 Identification of Unmet Survivorship Needs in Primary Lung Cancer Patients: A High Burden for Younger Patients M.E. Giuliani,1 R. Milne,1 J. Kwan,1 S. Alibhai,2 D. Howell,1 T. Waddell,1 N. Abdelmutti,1 G. Liu,1 J. Jones,1 P. Catton,1 and M. Puts1; 1Princess Margaret Cancer Centre, Toronto, ON, Canada, 2University Health Network, Toronto, ON, Canada Purpose/Objective(s): Few studies have explored the survivorship needs of lung cancer patients (LCP).The purpose of this study was to comprehensively determine the unmet supportive care and service delivery needs of this patient population. Materials/Methods: This cross sectional study used a validated selfadministered Supportive Care Needs Survey (SCNS) consisting of 34 items as well as a Service Delivery Needs Survey (SDNS) consisting of 8
items. Patients with primary lung cancer over the age of 18 in any phase of survivorship were included. Demographic data (age, gender, & stage) and treatment details were collected from participants’ medical charts. The proportion of patients with unmet needs and the mean number of unmet needs were determined. The mean number of unmet needs was compared by age group (<71 vs 71+), gender, and stage (1 vs higher) using Student’s T test. The most frequently reported unmet needs were determined. Results: From August 2013 to January 2014, 77 patients were recruited; 38 (49%) were male. The median age was 71 years (range 50-89). 40 (52%) had stage 1 LC. The mean number of unmet needs was 7 (range: 034) on the SCNS and 57 (74%) patients reported at least one unmet need. 67 (87%) indicated that they would like more information on at least one of these unmet needs. The mean number of unmet supportive care needs was 7.1 (0-34) for males and 7.2 (0-34) for females (p Z 0.48); was 9.1 (034) for age <71 and 5.6 (0-34) for age 71 (p Z 0.02); and was 6.5 (0-34) for stage 1 and 8.0 (0-34) for greater than stage 1 (p Z 0.21). The mean number of unmet needs was 4 (range: 0-8) on the SDNS and 69 (90%) of patients reported at least one unmet need on the SDNS. The mean number of unmet service delivery needs was 3.6 (0-8) for males and 3.6 (0-8) for females (p Z 0.43); was 4.6 (0-8) for age <71 and 2.9 (0-8) for age 71 (p<0.01); and was 3.3 (0-8) for stage 1 and 4.0 (0-8) for greater than stage 1 (p Z 0.07). The most frequent unmet supportive care needs were “Fears of cancer spreading”, 35 (46%) patients; “Lack of energy/tiredness”, 32 (42%) patients; “Uncertainty about the future”, 30 (39%) patients; and “Concerns about the worries of those close to you”, 30 (39%) patients. The most frequent unmet service delivery needs were “Information regarding shortness of breath”, 56 (73%); “Information on managing fatigue”, 57 (74%) patients; and “Information on managing cough”, 43 (56%) patients. Conclusions: Lung cancer patients have significant unmet survivorship needs, especially those under the age of 71. Further work is needed to determine why younger patients have greater survivorship needs and to develop programs and resources to address these needs. Author Disclosure: M.E. Giuliani: None. R. Milne: None. J. Kwan: None. S. Alibhai: None. D. Howell: None. T. Waddell: None. N. Abdelmutti: None. G. Liu: None. J. Jones: None. P. Catton: None. M. Puts: None.
3282 Radiation-Induced Malignant Mesothelioma: Frequency and Prognosis A.R. Barsky, J.S. Friedberg, M. Culligan, D.H. Sterman, E. Alley, L.A. Litzky, E. Glatstein, S.M. Hahn, K.A. Cengel, and C.B. Simone; University of Pennsylvania, Philadelphia, PA Purpose/Objective(s): Malignant mesothelioma (MM) has a known association with asbestos exposure, but more limited data exist suggesting other causative factors of MM. While prior radiation therapy (RT) is a risk factor for developing secondary malignancies like breast or thyroid, little data exist to suggest that MM develops secondarily to prior RT. We aimed to determine the frequency of prior in-field RT in patients with known MM. We hypothesized that these patients would have similar survival to patients with non-radiation-induced MM. Materials/Methods: All consecutive patients with pathologicallyconfirmed MM evaluated at our institution between 7/2010 and 12/2013 were included in this study. All patients were assessed for prior malignancies and previous treatment records were obtained to determine if prior RT was delivered to the site of the new MM. Patients treated with prior RT within 5 years of MM diagnosis, and thus thought not causally related, were excluded from analysis. Results: Of the 333 MM patients reviewed, 68 patients (20%) had a prior malignancy and 28 (8%) received prior RT. Eighteen (5%) of these patients were determined to have received prior in-field RT a median of 28.4 years prior to their MM diagnosis (range 8.8-77.8 years). These patients were predominantly Caucasian (94%) and female (56%) with stage III-IV disease (83%). They received prior RT to a median in-field dose of 45.0 Gy
Volume 90 Number 1S Supplement 2014 Author Disclosure: Z.H. Rana: None. R.L. Hong: None. D. McRae: None. G. Bernstein: None. R. Mordkin: None. A. Joel: None. N. Nasr: None.
3280 What Is the Impact of Survivorship Visits?: Preliminary Analysis From a NCI-Designated Cancer Center Radiation Oncology Program A. Leatherwood, O.V. Sostin, Y. Chen, and C.R. Thomas; Oregon Health and Science University, Portland, OR Purpose/Objective(s): Survivorship care in oncology has been a growing area; however, there is a lack of information regarding its effectiveness. We conducted a pilot study with specific aims to: 1) assess the impact of continuity cancer survivorship visits and survivorship care plans (SCPs) at our department on patient (pt) perception of provider support, 2) personal knowledge on post-treatment concerns, confidence in providers, 3) coordination of care between PCP and oncology providers, and 4) pt comfort level in finding additional information and answers regarding future postcancer health concerns. Materials/Methods: Patients who were definitively treated for a malignancy in our department and were seen by a dedicated survivorship nurse practitioner for a survivorship visit were asked to complete pre-test (5 items) and post-test (6 items) web-based questionnaires, which used Likert scale and were administered on an iPad mini immediately before the visit (pre-test) and at the conclusion of the visit (post-test). Scores of 1-5 were assigned to five levels of agreement (disagree, somewhat disagree, neutral, somewhat agree, and completely agree) respectively, and the responses from pre-test and post-test questionnaires were compared using Wilcoxon signed rank test. Results: Information of 63 pts was collected. The posttest scoring showed significant improvement from pretest scoring for all five questions (p-value from Wilcoxon signed rank test: < .01 for all questions). This suggests that overall, pts found the survivorship visit beneficial, which was also confirmed by mean difference values greater than 0 (range 0.43 to 0.84). While < 50% of all pts have noted an improvement for all five questions, 38 (60.3%) have found it useful in at least one question, and 10 (15.8%) have found it helpful for all questions. Conclusions: The preliminary results of our study suggest that overall, post-cancer treatment survivors feel that the survivorship visit and SCP are helpful. It improves their perception of provider support, personal knowledge on post-cancer treatment concerns, confidence level in the oncology provider team, trust in the coordination of care between PCP and oncology providers, and comfort level in finding additional information and answers regarding future post-cancer treatment concerns. More comprehensive, prospective studies will be needed in the future to confirm these observations. This approach may affirmatively impact survivorship care in clinical radiation therapy. Author Disclosure: A. Leatherwood: None. O.V. Sostin: None. Y. Chen: None. C.R. Thomas: None.
3281 Identification of Unmet Survivorship Needs in Primary Lung Cancer Patients: A High Burden for Younger Patients M.E. Giuliani,1 R. Milne,1 J. Kwan,1 S. Alibhai,2 D. Howell,1 T. Waddell,1 N. Abdelmutti,1 G. Liu,1 J. Jones,1 P. Catton,1 and M. Puts1; 1Princess Margaret Cancer Centre, Toronto, ON, Canada, 2University Health Network, Toronto, ON, Canada Purpose/Objective(s): Few studies have explored the survivorship needs of lung cancer patients (LCP).The purpose of this study was to comprehensively determine the unmet supportive care and service delivery needs of this patient population. Materials/Methods: This cross sectional study used a validated selfadministered Supportive Care Needs Survey (SCNS) consisting of 34 items as well as a Service Delivery Needs Survey (SDNS) consisting of 8
items. Patients with primary lung cancer over the age of 18 in any phase of survivorship were included. Demographic data (age, gender, & stage) and treatment details were collected from participants’ medical charts. The proportion of patients with unmet needs and the mean number of unmet needs were determined. The mean number of unmet needs was compared by age group (<71 vs 71+), gender, and stage (1 vs higher) using Student’s T test. The most frequently reported unmet needs were determined. Results: From August 2013 to January 2014, 77 patients were recruited; 38 (49%) were male. The median age was 71 years (range 50-89). 40 (52%) had stage 1 LC. The mean number of unmet needs was 7 (range: 034) on the SCNS and 57 (74%) patients reported at least one unmet need. 67 (87%) indicated that they would like more information on at least one of these unmet needs. The mean number of unmet supportive care needs was 7.1 (0-34) for males and 7.2 (0-34) for females (p Z 0.48); was 9.1 (034) for age <71 and 5.6 (0-34) for age 71 (p Z 0.02); and was 6.5 (0-34) for stage 1 and 8.0 (0-34) for greater than stage 1 (p Z 0.21). The mean number of unmet needs was 4 (range: 0-8) on the SDNS and 69 (90%) of patients reported at least one unmet need on the SDNS. The mean number of unmet service delivery needs was 3.6 (0-8) for males and 3.6 (0-8) for females (p Z 0.43); was 4.6 (0-8) for age <71 and 2.9 (0-8) for age 71 (p<0.01); and was 3.3 (0-8) for stage 1 and 4.0 (0-8) for greater than stage 1 (p Z 0.07). The most frequent unmet supportive care needs were “Fears of cancer spreading”, 35 (46%) patients; “Lack of energy/tiredness”, 32 (42%) patients; “Uncertainty about the future”, 30 (39%) patients; and “Concerns about the worries of those close to you”, 30 (39%) patients. The most frequent unmet service delivery needs were “Information regarding shortness of breath”, 56 (73%); “Information on managing fatigue”, 57 (74%) patients; and “Information on managing cough”, 43 (56%) patients. Conclusions: Lung cancer patients have significant unmet survivorship needs, especially those under the age of 71. Further work is needed to determine why younger patients have greater survivorship needs and to develop programs and resources to address these needs. Author Disclosure: M.E. Giuliani: None. R. Milne: None. J. Kwan: None. S. Alibhai: None. D. Howell: None. T. Waddell: None. N. Abdelmutti: None. G. Liu: None. J. Jones: None. P. Catton: None. M. Puts: None.
3282 Radiation-Induced Malignant Mesothelioma: Frequency and Prognosis A.R. Barsky, J.S. Friedberg, M. Culligan, D.H. Sterman, E. Alley, L.A. Litzky, E. Glatstein, S.M. Hahn, K.A. Cengel, and C.B. Simone; University of Pennsylvania, Philadelphia, PA Purpose/Objective(s): Malignant mesothelioma (MM) has a known association with asbestos exposure, but more limited data exist suggesting other causative factors of MM. While prior radiation therapy (RT) is a risk factor for developing secondary malignancies like breast or thyroid, little data exist to suggest that MM develops secondarily to prior RT. We aimed to determine the frequency of prior in-field RT in patients with known MM. We hypothesized that these patients would have similar survival to patients with non-radiation-induced MM. Materials/Methods: All consecutive patients with pathologicallyconfirmed MM evaluated at our institution between 7/2010 and 12/2013 were included in this study. All patients were assessed for prior malignancies and previous treatment records were obtained to determine if prior RT was delivered to the site of the new MM. Patients treated with prior RT within 5 years of MM diagnosis, and thus thought not causally related, were excluded from analysis. Results: Of the 333 MM patients reviewed, 68 patients (20%) had a prior malignancy and 28 (8%) received prior RT. Eighteen (5%) of these patients were determined to have received prior in-field RT a median of 28.4 years prior to their MM diagnosis (range 8.8-77.8 years). These patients were predominantly Caucasian (94%) and female (56%) with stage III-IV disease (83%). They received prior RT to a median in-field dose of 45.0 Gy