Structured journaling was associated with positive outcomes for symptom management, communication with the clinical care team, and quality of life (QOL) in patients with sarcoma. These study findings were published in the journal JCO Oncology Practice.

Treatment-related adverse events (TRAEs) may be a deterrence to completing therapy regimens in patients with sarcoma. Therefore, researchers at The Ohio State University aimed to investigate whether journaling may help patients feel empowered to advocate for improvements in symptom management.

The prospective, randomized trial ( Identifier: NCT03258892) involved patients with sarcoma undergoing systemic anticancer therapy (SACT). Patients were given a pocket-sized journal, the Sarcoma Treatment Guide (STG), to document their treatment, symptom characteristics, medical needs, and questions for their clinical care team, as well as other personal journaling.

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Trial arms emphasized early intervention vs late intervention, with a crossover design; arm A was given the STG prior to treatment, and arm B received the STG after the first 2 cycles of treatment. Patients participated in on-treatment surveys after cycles 2 and 4, in addition to an end-of-study survey. On-treatment surveys focused on symptom management, QOL, and communication with the clinical care team. The end-of-study survey focused on the value of the STG in the patient’s treatment. Call volume regarding patient TRAEs was measured. The primary endpoint was to determine whether symptom management and communication improved with the receipt of the STG in patients who were SACT naive.

The evaluable study population included 28 patients in arm A and 25 patients in arm B. Overall, differences in on-treatment survey responses between the treatment arms were not statistically significant. The mean call volume regarding TRAEs trended higher, but not significantly, for arm A during the first 2 cycles of SACT than for arm B (P =.20), and call volumes decreased in both groups over time.

In the overall population, 92% of evaluable participants reported the STG was at least moderately useful, with 42% considering it very useful. Symptoms reportedly improved for 57.9% of respondents upon using the STG to track symptoms and review them with the care team. Communication with physicians was considered to have at least moderately improved for 64% of respondents with use of the STG, and a similar result was obtained regarding communication with nursing staff (61%).

Patients who considered the STG to be useful also demonstrated improved scores for symptom management (Spearman’s r, 0.398; P =.011), QOL (Spearman’s r, 0.375; P =.019), and communication (Spearman’s r, 0.35; P =.027). Improved communication also correlated with better symptom management (Spearman’s r, 0.45; P =.002).

“In conclusion, structured journaling through the use of the STG was perceived to improve communication and symptom management in patients with sarcoma initiating systemic therapies,” the study investigators concluded. They noted that further studies should be performed to validate these findings.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Speece NJ, Xu M, Tinoco G, Liebner DA, Chen JL. Randomized prospective trial exploring the impact of structured journaling in patients with sarcoma on the management of treatment-related adverse events. JCO Oncol Pract. 2022;18(2):e250-e260. doi:10.1200/OP.21.00309