A pilot study tested whether use of a biometric wearable device (WD) could help predict outcomes in patients being treated for head and neck cancer. The compliance goal for the study was not met, but study findings suggested a connection between a reduction in an activity metric and reduced quality of life (QOL). The study results were reported in the journal JCO Clinical Cancer Informatics.
This prospective trial (ClinicalTrials.gov Identifier: NCT03574870) included patients with head and neck cancer who were being treated with definitive chemoradiotherapy or postoperative radiotherapy/chemoradiotherapy. Patients received a WD at least 1 week prior to the beginning of treatment, and were instructed to wear it for 23 hours per day. They were allowed to remove it for personal hygiene purposes.
The WD was able to record multiple metrics, such as step count, resting heart rate, and sleeping habits. With these data the researchers calculated weekly averages for each metric in addition to changes over time. The compliance goal for the study was 90%. For evaluating feasibility there were limitations to assessing hourly data, so the researchers reported on the proportion of patients with a willingness to continue wearing the WD. The researchers additionally evaluated outcomes related to hospitalizations and emergency department (ED) utilization, use of pain medication, and change in QOL on the FACT-G scale.
A total of 51 patients enrolled in the study and began wearing the WD; 8 patients chose to stop wearing it, resulting in a compliance level of 84%. Hospitalization or ED utilization was noted in 15 patients (35%) who were followed. Malnutrition with a requirement for a gastrostomy tube was the reason for the hospital or ED encounter for 13 of these patients.
In the first week of therapy, the mean FACT-G score was 85.9 (SD, 14.0), and the mean FACT-G during the final week of therapy was 76.6 (SD, 18.7), for an average difference over time of −9.5 (SD, 16.2; P =.002). A total of 25 patients showed a reduction in FACT-G of 10 or more points across the study period. Among this subset of patients, in the week prior to significant QOL decline, there was an average reduction in daily steps of 988 steps (P =.005). For these patients, the average reduction in daily steps during the weekend before decline was 1311 (P =.018). Patients showing a week-to-week reduction in 1000 or more daily steps were more than 4 times as likely to experience a reduction in QOL (odds ratio, 4.20; 95% CI, 1.02-17.32; P =.040).
“This study did not find strong evidence that an activity tracker could facilitate an early intervention for patients at risk for a hospital encounter or pain during head and neck radiotherapy, but the relationship between activity change and QOL is provocative,” the researchers concluded.
Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Sher DJ, Radpour S, Shah JL, et al. Pilot study of a wearable activity monitor during head and neck radiotherapy to predict clinical outcomes. JCO Clin Cancer Inform. 2022;6:e2100179. doi:10.1200/CCI.21.00179