An Assessment of Technology Usage and Barriers to Adoption Among Patients in a Radiation Oncology Clinic

Abstract

variables and ESAS scores were analyzed using the Mann Whitney U test and correlations between variables were calculated by Kendall's tau-b tests.Results: 87 patients with EsoCa completed ESAS between 2/16 2017 and 7/ 21 2019. Of these patients, 44 completed 3 ESAS surveys (median Z 5, mean 5.7, range 3-12) while on treatment and form the cohort further analyzed. In this cohort, the majority were men (77.3%, nZ34) and white/ Caucasian (nZ95.5%, nZ42). Seven (16%) patients had cervical esophageal lesions, four (9%) had middle lesions and 33 (75%) had distal lesions. The majority of patients had adenocarcinoma (75%, nZ33). The ESAS item with the highest median score was tiredness (4.25) with a median total score of 19.75. Patients with middle lesions were more likely to experience pain (4.25 v. 0.25, pZ0.028) and drowsiness (2.5 v. 0, pZ0.017), but no statistically significant relationships were seen for those with distal or cervical lesions. Patients with squamous cell carcinoma were more likely to experience anxiety (3 v. 0, pZ0.047), although this may represent a statistical aberration. The strongest correlation between symptoms were found between depression and spiritual pain (tb 0.609, pZ0.000). Drowsiness was correlated with the most symptoms, including shortness of breath (0.346, pZ0.0090), pain (0.447, pZ0.000), tiredness (0.344, pZ0.005), nausea (0.424, pZ0.001), depression (0.363, pZ0.007), and insomnia (0.323, pZ0.009). Conclusions: In this large analysis of PRO in EsoCa, patients with middle esophageal lesions were more likely to experience pain and drowsiness, while those with squamous cell carcinoma reported more anxiety. Uncontrolled esophageal pain could lead to unanticipated interval hospitalizations or IV fluid interventions so further analysis with large PRO libraries is indicated to validate these findings.