Case Series: Can Daily Patient‐Reported Outcome Measures Be Implemented for Cancer‐Related Fatigue?
Alexander Tilg, Andreas Meryk, Johannes G. Weiss, Roman CrazzolaraABSTRACT
Background
Cancer‐related fatigue (CrF), a prevalent and debilitating symptom among cancer patients, remains underrecognized and unstandardized in routine oncology care. To address this, we introduced a new digital tool for daily CrF measurement and integration in routine cancer treatment.
Case
This case series investigates the use of the ePROtect app for daily CrF assessment in two pediatric acute lymphoblastic leukemia (ALL) patients. Data were collected up to 2 weeks after the end of intensive therapy (before the start of maintenance) and analyzed using two questions informed by the National Comprehensive Cancer Network (NCCN), each offering five possible responses and categorizing fatigue into different subclasses. This analysis compares two 3‐year‐old girls with pre‐B ALL, one with standard risk (SR) and favorable genetics, the other one with poor therapy response and stratified to high risk (HR) treatment. The SR patient responded well to treatment, experiencing severe CrF on only 6% of the treatment days. In contrast, the HR patient required intensified treatment with multiple re‐induction phases, resulting in more frequent hospitalizations and severe CrF on 19.4% of the treatment days. CrF assessments were conducted daily for both patients, achieving 98.6% and 69.5% completion rates throughout intensive therapy, for the SR and HR patient, respectively.
Conclusion
This case series illustrates the feasibility and potential suitability of our tool using PROMs for CrF assessment. Furthermore, it highlights the correlation between treatment intensity, complications, and CrF levels, underlying the importance of systematically measuring fatigue in cancer patients. Such measurement may inform future efforts to develop and refine individualized supportive care strategies.