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Original article
peer-reviewed

A Pilot Study in the Use of Activity Trackers for Assessing Response to Palliative Radiotherapy



Abstract

Purpose

Radiation therapy (RT) has been a frequently used treatment for painful bone metastasis. The aim of this study was to determine the feasibility of using activity trackers (AT) to assess the patient prognosis and the effects of palliative RT.

Methods and materials

Twelve patients planned to receive palliative RT for axial metastases and were prospectively recruited to participate in this pilot clinical trial. The patients were eligible if there was no intent to change the analgesic medications prior to or within seven days of palliative RT. All the patients were lent a Misfit FlashTM activity tracker (Misfit, Burlingame, California, United States of America) and were asked to wear it from the time of baseline assessment prior to RT until seven days after RT. The patients completed the European Organisation for Research and Treatment of Cancer quality of life (QOL) questionnaire (EORTC-QLQ C30) and the Short Form Brief Pain Inventory (SF-BPI) before the treatment and at days seven, 30 and 90 after completion of the RT. The patients' Karnofsky Performance Status (KPS) was assessed at each visit. The patients' overall survival at the end of the RT was recorded. Average daily steps before and after RT were compared using paired Wilcoxon signed-rank test. The patients' overall survival was estimated using the Kaplan-Meier curve and analyzed using the Log-Rank test.

Results

The median age of the patients was 62 years (range: 40-79 years). Of the 12 patients, there were five prostate, three breasts, three lungs, and one colon cancer-related patients. Six patients received 20 Gray (Gy) in five fractions and six received 8 Gy in one fraction. By day seven, post-RT, there was a 30% (p <0.02) reduction in the patients' daily activity level. There was no correlation between improvements in the QOL or with the level of pain and with the number of daily steps. While baseline KPS was not prognostic of the patient survival, the patients who on average took more than 7800 steps per day prior to RT lived significantly (p=0.034) longer than those who were less active.

Conclusions

The baseline activity level is associated with the patient prognosis. A significant decline in the physical activity was observed at one week after palliative RT. The use of activity trackers was to prognosticate and to monitor the patients' response to the palliative RT and should be evaluated further.



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Original article
peer-reviewed

A Pilot Study in the Use of Activity Trackers for Assessing Response to Palliative Radiotherapy


Author Information

Valérie Dorion

Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal (chum)

Louise Lambert

Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)

Alexandra Frazzi

Unité De Recherche Clinique En Oncologie Et Hématologie, Centre Hospitalier de l’Université de Montréal

Jean-François Cayer

Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal

Philip Wong Corresponding Author

Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. CHUM Ethics Board, Quebec, Canada issued approval 14.046. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

Université de Montréal, support professor of the Department of the Radiology, Radiation Oncology and Nuclear Medicine.


Original article
peer-reviewed

A Pilot Study in the Use of Activity Trackers for Assessing Response to Palliative Radiotherapy


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Original article
peer-reviewed

A Pilot Study in the Use of Activity Trackers for Assessing Response to Palliative Radiotherapy

Valérie Dorion">Valérie Dorion, Louise Lambert">Louise Lambert, Alexandra Frazzi">Alexandra Frazzi, Jean-François Cayer">Jean-François Cayer, Philip Wong">Philip Wong

  • Author Information
    Valérie Dorion

    Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal (chum)

    Louise Lambert

    Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)

    Alexandra Frazzi

    Unité De Recherche Clinique En Oncologie Et Hématologie, Centre Hospitalier de l’Université de Montréal

    Jean-François Cayer

    Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal

    Philip Wong Corresponding Author

    Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. CHUM Ethics Board, Quebec, Canada issued approval 14.046. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    Université de Montréal, support professor of the Department of the Radiology, Radiation Oncology and Nuclear Medicine.


    Article Information

    Published: November 22, 2017

    DOI

    10.7759/cureus.1871

    Cite this article as:

    Dorion V, Lambert L, Frazzi A, et al. (November 22, 2017) A Pilot Study in the Use of Activity Trackers for Assessing Response to Palliative Radiotherapy. Cureus 9(11): e1871. doi:10.7759/cureus.1871

    Publication history

    Received by Cureus: September 15, 2017
    Peer review began: October 11, 2017
    Peer review concluded: November 19, 2017
    Published: November 22, 2017

    Copyright

    © Copyright 2017
    Dorion et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Purpose

Radiation therapy (RT) has been a frequently used treatment for painful bone metastasis. The aim of this study was to determine the feasibility of using activity trackers (AT) to assess the patient prognosis and the effects of palliative RT.

Methods and materials

Twelve patients planned to receive palliative RT for axial metastases and were prospectively recruited to participate in this pilot clinical trial. The patients were eligible if there was no intent to change the analgesic medications prior to or within seven days of palliative RT. All the patients were lent a Misfit FlashTM activity tracker (Misfit, Burlingame, California, United States of America) and were asked to wear it from the time of baseline assessment prior to RT until seven days after RT. The patients completed the European Organisation for Research and Treatment of Cancer quality of life (QOL) questionnaire (EORTC-QLQ C30) and the Short Form Brief Pain Inventory (SF-BPI) before the treatment and at days seven, 30 and 90 after completion of the RT. The patients' Karnofsky Performance Status (KPS) was assessed at each visit. The patients' overall survival at the end of the RT was recorded. Average daily steps before and after RT were compared using paired Wilcoxon signed-rank test. The patients' overall survival was estimated using the Kaplan-Meier curve and analyzed using the Log-Rank test.

Results

The median age of the patients was 62 years (range: 40-79 years). Of the 12 patients, there were five prostate, three breasts, three lungs, and one colon cancer-related patients. Six patients received 20 Gray (Gy) in five fractions and six received 8 Gy in one fraction. By day seven, post-RT, there was a 30% (p <0.02) reduction in the patients' daily activity level. There was no correlation between improvements in the QOL or with the level of pain and with the number of daily steps. While baseline KPS was not prognostic of the patient survival, the patients who on average took more than 7800 steps per day prior to RT lived significantly (p=0.034) longer than those who were less active.

Conclusions

The baseline activity level is associated with the patient prognosis. A significant decline in the physical activity was observed at one week after palliative RT. The use of activity trackers was to prognosticate and to monitor the patients' response to the palliative RT and should be evaluated further.



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Valérie Dorion

Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal (chum)

Louise Lambert

Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)

Alexandra Frazzi

Unité De Recherche Clinique En Oncologie Et Hématologie, Centre Hospitalier de l’Université de Montréal

Jean-François Cayer

Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal

Philip Wong

Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)

For correspondence:
pwong.kf@gmail.com

Valérie Dorion

Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal (chum)

Louise Lambert

Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)

Alexandra Frazzi

Unité De Recherche Clinique En Oncologie Et Hématologie, Centre Hospitalier de l’Université de Montréal

Jean-François Cayer

Department of Radiation Oncology, Centre Hospitalier De L’université De Montréal

Philip Wong

Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM)

For correspondence:
pwong.kf@gmail.com