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Randomized Trial Comparing a Web-Mediated Follow-up With Routine Surveillance in Lung Cancer Patients.

Abstract The use of web-based monitoring for lung cancer patients is growing in interest because of promising recent results suggesting improvement in cancer and resource utilization outcomes. It remains an open question whether the overall survival (OS) in these patients could be improved by using a web-mediated follow-up rather than classical scheduled follow-up and imaging.
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Authors

Mayor MeshTerms
Keywords
Journal Title journal of the national cancer institute
Publication Year Start




PMID- 28423407
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170419
IS  - 1460-2105 (Electronic)
IS  - 0027-8874 (Linking)
VI  - 109
IP  - 9
DP  - 2017 Sep 01
TI  - Randomized Trial Comparing a Web-Mediated Follow-up With Routine Surveillance in 
      Lung Cancer Patients.
LID - 10.1093/jnci/djx029 [doi]
AB  - Background: The use of web-based monitoring for lung cancer patients is growing
      in interest because of promising recent results suggesting improvement in cancer 
      and resource utilization outcomes. It remains an open question whether the
      overall survival (OS) in these patients could be improved by using a web-mediated
      follow-up rather than classical scheduled follow-up and imaging. Methods:
      Advanced-stage lung cancer patients without evidence of disease progression after
      or during initial treatment were randomly assigned in a multicenter phase III
      trial to compare a web-mediated follow-up algorithm (experimental arm), based on 
      weekly self-scored patient symptoms, with routine follow-up with CT scans
      scheduled every three to six months according to the disease stage (control arm).
      In the experimental arm, an alert email was automatically sent to the oncologist 
      when self-scored symptoms matched predefined criteria. The primary outcome was
      OS. Results: From June 2014 to January 2016, 133 patients were enrolled and 121
      were retained in the intent-to-treat analysis; 12 deemed ineligible after random 
      assignment were not subsequently followed. Most of the patients (95.1%) had stage
      III or IV disease. The median follow-up was nine months. The median OS was 19.0
      months (95% confidence interval [CI] = 12.5 to noncalculable) in the experimental
      and 12.0 months (95% CI = 8.6 to 16.4) in the control arm (one-sided P = .001)
      (hazard ratio = 0.32, 95% CI = 0.15 to 0.67, one-sided P = .002). The performance
      status at first detected relapse was 0 to 1 for 75.9% of the patients in the
      experimental arm and for 32.5% of those in the control arm (two-sided P < .001). 
      Optimal treatment was initiated in 72.4% of the patients in the experimental arm 
      and in 32.5% of those in the control arm (two-sided P < .001). Conclusions: A
      web-mediated follow-up algorithm based on self-reported symptoms improved OS due 
      to early relapse detection and better performance status at relapse.
FAU - Denis, Fabrice
AU  - Denis F
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Lethrosne, Claire
AU  - Lethrosne C
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Pourel, Nicolas
AU  - Pourel N
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Molinier, Olivier
AU  - Molinier O
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Pointreau, Yoann
AU  - Pointreau Y
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Domont, Julien
AU  - Domont J
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Bourgeois, Hugues
AU  - Bourgeois H
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Senellart, Helene
AU  - Senellart H
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Tremolieres, Pierre
AU  - Tremolieres P
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Lizee, Thibaut
AU  - Lizee T
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Bennouna, Jaafar
AU  - Bennouna J
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Urban, Thierry
AU  - Urban T
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - El Khouri, Claude
AU  - El Khouri C
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Charron, Alexandre
AU  - Charron A
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Septans, Anne-Lise
AU  - Septans AL
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Balavoine, Magali
AU  - Balavoine M
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Landry, Sebastien
AU  - Landry S
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Solal-Celigny, Philippe
AU  - Solal-Celigny P
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
FAU - Letellier, Christophe
AU  - Letellier C
AD  - Affiliations of authors: Institut Inter-regional de Cancerologie Jean Bernard, Le
      Mans, France (FD, YP, JD, HB, AC, SL); CORIA UMR 6614-Normandie Universite, CNRS 
      Universite et INSA de Rouen, Campus Universitaire du Madrillet, Saint-Etienne du 
      Rouvray, France (FD, CLete); Service de pneumologie, Centre Hospitalier, Le
      Coudray, Chartres, France (CLeth); Institut Sainte Catherine, Avignon, France
      (NP); Service de pneumologie, Centre Hospitalier, Le Mans, France (OM); Institut 
      de Cancerologie de l'Ouest Rene Gauducheau, St Herblain, France (HS, JB, PSC);
      Institut de Cancerologie de l'Ouest Paul Papin, Angers, France (PT, TL, ALS, MB);
      Service de pneumologie, Centre Hospitalier Universitaire, Angers, France (TU);
      Institut Catherine de Sienne, Nantes, France (CEK).
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Natl Cancer Inst
JT  - Journal of the National Cancer Institute
JID - 7503089
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
PHST- 2016/08/18 [received]
PHST- 2017/02/07 [accepted]
AID - 3573360 [pii]
AID - 10.1093/jnci/djx029 [doi]
PST - ppublish
SO  - J Natl Cancer Inst. 2017 Sep 1;109(9). doi: 10.1093/jnci/djx029.

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