Health Services Research

PV 03 - Poster Viewing Q&A - Session 3

TU_10_3057 - Real-time Activity Monitoring to Prevent Admissions during RadioTherapy (RAMPART)

Tuesday, September 17
1:00 PM - 2:15 PM
Location: ASTRO Innovation Hub

Real-time Activity Monitoring to Prevent Admissions during RadioTherapy (RAMPART)
T. Y. Andraos1, A. M. Asaro1, M. K. Garg1, W. R. Bodner III1, R. Kabarriti1, C. Zanartu2, S. Kalnicki1, and N. Ohri1; 1Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, 2Palliative Medicine, Montefiore Einstein Center for Cancer Care, Bronx, NY

Purpose/Objective(s): A pilot study demonstrated that daily step counts during concurrent chemoradiotherapy for head/neck, lung, and gastrointestinal cancers can be measured using wearable devices, and low step counts are associated with increased short-term hospitalization risk. This trial tested a wearable device-based strategy to reduce the rate of hospitalization during chemoradiotherapy.

Materials/Methods: Ambulatory patients with ECOG performance status (PS) 0-2 who were planned for treatment with definitive concurrent chemoradiotherapy for a cancer of the head/neck, lung, esophagus, or stomach were eligible for this trial. Based on findings from a previous study, an Activity Score (AS) was calculated for each subject every Monday during radiotherapy as follows: AS = (average daily step count over the past weekend) + (change in that value compared to the preceding weekend). Subjects with AS below 1,600 were deemed to be at high risk for hospitalization and scheduled for physician visits in the Radiation Oncology department each day that week. Referrals to Nutrition, Palliative Care, and Physical Medicine and Rehabilitation were also made, at the discretion of the treating physicians. The primary study endpoint was hospitalization during radiotherapy or within four weeks after radiotherapy completion.

Results: Thirty-eight adult subjects with head and neck cancer (n=17), lung cancer (n=14), or esophageal/gastric cancer (n=7) were enrolled. Baseline PS was 0 for 10 subjects, 1 for 22 subjects, and 2 for 6 subjects. Step data were collected for 1,557 out of 1,682 days (93%) during subjects’ radiotherapy courses. Fourteen subjects (37%) were hospitalized during the study period, which did not meet the pre-specified efficacy endpoint. Reasons for hospitalization included inanition/dehydration (n=5), fever/infection (n=3), and nausea/vomiting (n=3). Six subjects were first hospitalized in the setting of AS below 1,600 (6 out of 71, 8%), five were hospitalized with AS above 1,600 (5 out of 195, 3%), and three were hospitalized when activity data were not captured. Logistical challenges encountered during the study included difficulty scheduling rapid evaluations by providers from other specialties, unavailability of pain medications at some local pharmacies, and subjects removing their devices to avoid extra clinician visits.

Conclusion: While activity data can help predict hospitalizations during chemoradiotherapy, additional study is required to identify effective interventions to prevent unplanned admissions. We are currently testing a pedometer-based walking program to promote physical activity and try to reduce adverse events during chemoradiotherapy.

Author Disclosure: T. Andraos: None. M.K. Garg: Speaker's Bureau; Varian, Covidien. W.R. Bodner: None. R. Kabarriti: None. S. Kalnicki: Travel Expenses; Varian Oncology Systems. Committee Member; American College of Radiology. N. Ohri: Consultant; Merck.

Therese Youssef Andraos, MD

Montefiore Medical Center/Albert Einstein College of Medicine


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TU_10_3057 - Real-time Activity Monitoring to Prevent Admissions during RadioTherapy (RAMPART)

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