title: Investigation of a Patient Reported Outcome tool to assess radiotherapy-related toxicity prospectively in patients with lung cancer.
abstract: OBJECTIVE
  There is a paucity of data regarding the feasibility and relevance of Patient Reported Outcome (PRO) tools to assess radiotherapy-related toxicity in lung cancer.
  
  
  METHODS
  From January to June 2013, lung cancer patients undergoing thoracic radiotherapy/chemo-radiotherapy completed nine patient-adapted Common Terminology Criteria for Adverse Events (CTCAE), the European Organisation for Research and Treatment of Cancer Quality of Life (QoL) questionnaire and the Hospital Anxiety and Depression Scale (HADS) at baseline, the end of radiotherapy and at follow-up. Clinicians completed the same CTCAE items and agreement between patients' and clinicians' reporting was assessed using weighted kappa coefficients. QoL and HADS scores were correlated with the patients' and clinicians' reported toxicity.
  
  
  RESULTS
  70/116 patients completed the questionnaires for at least one time point excluding baseline. Agreement between patients' and clinicians' reported toxicity ranged from slight to substantial. Most discrepancies were within one grade and patients reported greater severity than clinicians for most symptoms. QoL and HADS scores were more strongly correlated with the patients' compared to clinicians' matching toxicity reports. The PRO tool was found to be statistically reliable.
  
  
  CONCLUSIONS
  The use of a PRO tool in lung cancer radiotherapy is feasible, reliable and acceptable to patients. PROs should be integrated in future clinical trials evaluating new radiotherapy approaches to assess toxicity.
authors.affiliation: The University of Manchester, Greater Manchester, United Kingdom.
authors.forename: Marianna
authors.initials: M
authors.lastname: Christodoulou
authors.affiliation: Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Paula
authors.initials: P
authors.lastname: McCloskey
authors.affiliation: Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Nicola
authors.initials: N
authors.lastname: Stones
authors.affiliation: Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Bayman
authors.affiliation: Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Burt
authors.affiliation: Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Abbas
authors.initials: A
authors.lastname: Chittalia
authors.affiliation: Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Margaret
authors.initials: M
authors.lastname: Harris
authors.affiliation: Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Lip
authors.initials: L
authors.lastname: Lee
authors.affiliation: Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Laura
authors.initials: L
authors.lastname: Pemberton
authors.affiliation: Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Hamid
authors.initials: H
authors.lastname: Sheikh
authors.affiliation: Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Ric
authors.initials: R
authors.lastname: Swindell
authors.affiliation: The University of Manchester, Greater Manchester, United Kingdom; Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom; Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. Electronic address: corinne.finn@christie.nhs.uk.
authors.forename: Corinne
authors.initials: C
authors.lastname: Faivre-Finn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011788:Quality of Life; D011832:Radiation Injuries / Q000175:diagnosis*; D011878:Radiotherapy / Q000009:adverse effects; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Lung cancer; Patient-reported outcomes; Radiotherapy; Toxicity