London | Scientists have developed a new mobile app for advanced lung cancer patients that may improve their quality of life and survival rates by allowing them to give and receive continuous feedback between doctor visits.
Researchers analysed the association and evolution of self-reported clinical symptoms over time in a randomised study. The median overall survival of patients who used the web-mediated follow-up application was 19 months, compared to 12 months for those who received standard follow-up care.
Quality of life was also better among patients who used the application, researchers said. Through personalised follow-up using this convenient and simple online application, we can detect complications and signs of relapse and offer appropriate care earlier, said Fabrice Denis, researcher at the Institut Inter-regional de Cancerologie Jean Bernard in France.
This approach introduces a new era of follow-up in which patients can give and receive continuous feedback between visits to their oncologist, said Denis. This is the first randomised trial showing a major improvement in survival with web-mediated follow-up versus standard follow-up, researchers said.
It is also the first time that an algorithm for early detection of a symptomatic relapse or complication was used to trigger early supportive care or treatment, they said. After completing initial chemotherapy, radiation therapy, or surgery, 133 patients with stage III/IV lung cancer were randomly assigned to web-mediated follow-up or standard follow-up.
The standard follow-up included doctor visits and CT scans every 3-6 months. Patients in the web-application group had the same schedule of planned doctor visits but three times fewer scheduled scans.
They used the web application to self-assess symptoms weekly. The application analysed 12 symptoms and reported results to the oncologist. An algorithm assessed specific changes in symptoms and triggered email alerts for the doctor, who would then confirm the need of anticipated exams/visits to adapt cancer treatment, including supportive care options.
At one year, 75 per cent of patients were still alive in the web-application group, compared to 49 per cent in the standard follow-up group. Relapse rates were similar in both groups: 51 per cent and 49 per cent in the standard and web-application groups, respectively.
Patient well-being at relapse was good in web-application group, so 74 per cent of those patients were able to receive the full recommended treatment for the recurrence. In contrast, only one-third of patients in the standard follow-up group were well enough to receive optimal treatment for cancer recurrence.
Overall quality of life was better in the web-application group. Web-application follow-up also reduced by 50 per cent the average number of imaging tests per patient per year.
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