Background Wearable activity monitors are widely available and marketed as fitness trackers. We performed a prospective trial testing the feasibility and utility of acquiring activity data as a measure of health status during concurrent chemoradiotherapy. Methods Ambulatory patients who were planned for treatment with concurrent chemoradiotherapy with curative intent for cancers of the head and neck, lung, or gastrointestinal (GI) tract were provided with activity monitors prior to treatment initiation. Patients were asked to wear the devices continuously throughout the radiotherapy course. Step count data were downloaded at weekly during radiotherapy and two and four weeks after radiotherapy completion. The primary objective was to demonstrate feasibility, defined as collection of step counts for 80% of the days during study subjects’ radiotherapy courses. Secondary objectives included establishing step count as a dynamic predictor of unplanned hospitalization risk. Results Thirty-eight enrolled patients were treated with concurrent chemoradiotherapy. Primary diagnoses included head and neck cancer (n=11), lung cancer (n=13), and a variety of GI cancers (n=14). Step data were collected for 1524 out of 1613 days (94%) during patients’ radiotherapy courses. Fourteen patients were hospitalized during radiotherapy or within four weeks of radiotherapy completion. Cox regression modeling demonstrated a significant association between recent step counts (3-day average) and hospitalization risk, with a 38% reduction in the risk of hospitalization for every 1,000 steps taken each day (HR = 0.62, 95% CI: 0.46 to 0.83, p=0.002). Inferior quality of life scores and impaired performance status were not associated with increased hospitalization risk. Conclusion Continuous activity monitoring during concurrent chemoradiotherapy is feasible and well-tolerated. Step counts may serve as powerful, objective, and dynamic indicators of hospitalization risk.

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