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Background: CALGB 30610 trial demonstrated that once daily thoracic radiotherapy (TRT) was not superior compared to standard twice daily TRT, in patients with limited stage small cell lung cancer. Quality of life outcomes may help oncologists decide the best treatment approach., Methods: A total of 417 patients on CALGB 30610 participated in the quality-of-life substudy (CALGB 70702), which included the FACT Trial Outcome Index-Lung Cancer (FACT-L TOI), FACT-Esophageal Cancer (FACT-E) Eating and Swallowing Indices, ECOG Acute Esophagitis Scale, Hospital Anxiety and Depression Scale (HADS), difficulty swallowing, EQ-5D, and treatment convenience assessment at baseline, 3, 5, 7, 12, 26, and 52 weeks after starting TRT. Primary end points included FACT-L TOI and FACT-E at 12 weeks. Mean changes from baseline were compared between arms using general linear mixed models., Results: FACT-L worsening was more in the twice daily arm at week 3 (-1.0 vs. -7.0). FACT-L TOI worsening was less at week 3 (-2.9 vs. -7.6) and greater at week 12 (-7.6 vs. -2.8) in the once daily arm. The once daily arm had a lower EQ-5D index worsening at 3 weeks (0.01 vs. -0.02). Increase in acute esophagitis score (1.06 vs. 2.89; p < .001) and difficulty swallowing (0.39 vs. 1.14) were greater in the twice daily arm at week 3. A total of 74.5% of patients on the once daily arm felt that treatment was convenient, compared to 67% of patients in the twice daily arm (p = .03)., Conclusions: The once daily arm had better quality-of-life scores earlier during treatment and was perceived to be more convenient., (© 2024 American Cancer Society.)

Background: The Veterans Affairs Nebraska Western Iowa Health Care System (VA-NWIHCS) uses teleoncology and remote systemic cancer therapy services to expand care to veterans in rural Nebraska via remote sites in Lincoln and Grand Island. This study compares clinical outcomes in patients receiving care at these remote sites to those at the primary site in Omaha., Methods: Data were retrospectively reviewed for 151 patients who received first-line systemic therapy at VA sites in Omaha, Lincoln, or Grand Island between January 1, 2018, and December 31, 2020. This included patient demographics, malignancy type and stage, survival, systemic therapy received, treatment intent and toxicities, missed or delayed cycles, and frequency of hospitalizations or emergency department visits. SAS version 9.4 was used for analysis., Results: The study population included 108 patients who received their systemic therapy in Omaha, whereas 43 received therapy at the remote sites. The demographic of both populations was predominantly male with a median age of 69 years and Eastern Cooperative Oncology Group Performance Status of 0 to 1. The two groups were comparable in terms of comorbidities. Both populations had a similar distribution of cancer types, proportion of patients with stage IV disease, and treatment with curative intent. There was no difference in 1- and 2-year survival, systemic therapy-related toxicity classification and prevalence, number of delayed/missed cycles, and hospitalization/emergency department visits., Conclusion: Evaluated outcomes in patients treated in Omaha versus remote sites via teleoncology under the same providers were similar. Effective oncology care, including systemic therapy, can be provided via teleoncology, and this model can help mitigate issues with access to care., (© 2024 American Cancer Society.)