(P 157) QUALITY OF LIFE DURING TREATMENT FOR METASTATIC SARCOMA - FEASIBILITY OF ELECTRONIC PATIENT REPORTED OUTCOMES

Objective: Patients with metastatic sarcoma have multiple complex symptoms. Systematic assessment of patient reported outcome (PRO) measures from patients with sarcoma provide insight into the effectiveness of care from the patient perspective. This is particularly valable information in rare cancers where PRO data from large randomized trials are scarce.
In the Danish PRO Sarcoma project, electronic versions of validated PRO instruments are used to capture data on health realted quality of life (HR-QoL) during sarcoma treatment, for use in daily practice as well as for quality assurance in the Danish Sarcoma Database. Patient self-report using electronic PRO instruments can itself improve symptom-management, communication, HRQoL and satisfaction with care. Furthermore, PRO measures can help identify patients that need supportive or rehabilitation interventions, and ultimately improve quality of life during treatment.
In this feasibility study, we present PRO data from the PRO sarcoma project in a well defined group of patients with metastatic soft tissue sarcoma.

Methods: Patients 18 years of age or older with metastatic or locally advanced soft tissue sarcoma receiving palliative combination treatment with gemcitabin and dacarbazine at the Department of Clinical Oncology, Copenhagen University Hospital at Herlev, Denmark, between May 1st 2021 and March 28th 2023 were included in this retrospective study. All patients had the option to fill in Danish language versions of the EORTC QLQ C30 questionnaire which are sent electronically via an app (minSP by EPIC) connected to the patient´s electronic patient record (Sundhedsplatformen by EPIC). Questionnaires are accessible 7 days before the clinic appointment. Only clinic appointments with scan results and assessment of further treatment strategy are linked to PRO questionnaires. Clinical data as well as PRO data were collected from electronic patient records. Clinical characteristics of patients with and without reported PRO data are presented, as well as data on HR-QoL during treatment with gemcitabin and dacarbazine. Time to progression (TTP) and overall survial (OS) were assessed for the whole group using the Kaplan Meier model.

Results: 29 patients, 20 women and 9 men, received palliative treatment with gemcitabin and dacarbazine between May 1st 2021 and March 28th 2023. Most of the participants (27 out of 29) were diagnosed with leiomyosarcoma; two patients were treated for metastatic solitary fibrous tumour. Fifteen patients (11 women/4 men, median age 67 years) provided PRO data from one ore more EORTC QLQ C-30 questionnaire during treatment with gemcitabin and dacarbazine. There was no difference with regards to age, gender, sarcoma subtype, treatment line or treatment length between the patients that provided PRO data and the patients that did not provide any data. Median HR-QoL was 58,33 (range 31-100, N = 15) at the first assessment during treatment. At the second assessment, median QoL was 66,67 (range 44-83,33, N = 7). At the third assessment, median HR- QoL was 75 (range 50-91,67, N = 4). For two patients that provided four sets of PRO data, HR-QoL was 66,67 and 75. Median OS for the whole group was 1.56 years (95%CI: 1.13-2.45), median TTP 0.64 years (95%CI: 0.37-0.97).

Conclusion: This single center experience shows that electronic PRO capture in patients with metastatic sarcoma undergoing palliative treatment is feasible and shows substantial and clinically significant impairment of HR-QoL that calls for intervention. This data set does not provide any information about the reasons why almost half of the eligible patient choose not to answer the electronic PRO instruments, and no significant clinical differences between the groups of responders and non-responders are found. Survival data are comparable to data from the literature. Nationwide PRO capture as established in the Danish PRO Sarcoma project will provide further insight to HR-QoL for patients with sarcoma during and after treatment.