T. Wessels Archives

A digital automated health monitoring system for oncology patients during the COVID-19 pandemic: practical issues and lessons for the future

BJMO - volume 15, issue 6, october 2021

J. Robijns PhD, J. Lodewijckx MSc, K. Wijnen PhD, S. Snoekx MSc, R. Hilkens RN , S. Bortels RN , H. Lenders RN , W. Nassen RN , E. Dewaele MD, D. Luyten MD, E. Joosens MD, A. Requilé MD, Y. Verheezen MD, T. Wessels MD, P. Bulens MD, J. Mebis MD

SUMMARY

During the COVID-19 pandemic, patients with cancer are subject to multiple risks (e.g., frequent hospital visits, increased infection risk, more severe clinical course, discontinued cancer treatment). Patients undergoing cancer therapy can face quality of life (QoL) – impairing side effects. Both for COVID-19 positive and negative patients who will continue or discontinue cancer treatment throughout the pandemic, providing supportive care is more important than ever. Digitally monitoring patient-reported outcome measures (PROMs) could offer a solution to improve the supportive care during cancer treatment, and certainly in times of COVID–19.

A prospective cohort trial was performed between August 2020 and February 2021 at the Jessa Hospital (Hasselt, Belgium), evaluating the feasibility and usability of a digital patient monitoring (DPM) system to collect PROMs of oncology patients undergoing chemotherapy during the COVID-19 pandemic. Based on available evidence from our trial, digitalised PROMs could significantly contribute to improved communication, patient satisfaction, supportive care, monitoring cancer treatment, and detecting problems. However, the DPM system needs fine-tuning to lead to a patient and healthcare worker-friendly system, fully incorporated in the electronic health records without losing the personal contact between patient and healthcare team.

(BELG J MED ONCOL 2021;15(6):292-303)

Clinical presentation, natural history and therapeutic approach in patients with solitary fibrous tumor: a retrospective analysis

BJMO - 2019, issue 2, february 2019

T. Wessels MD

Introduction

Solitary fibrous tumor (SFT), a rare variant of soft tissue sarcoma (STS), is characterized by the presence of a NAB2-STAT6 fusion. Given the orphan character of SFT we performed a retrospective analysis.

Materials and methods

We retrospectively reviewed all patients (pts) with SFT treated in our institution between 12/1990 – 09/2017.

Results

We identified 94 SFT pts (incl. hemangiopericytoma) with a med. follow-up for 4.7 yrs. Common anatomic sites were chest (33%), abdomen (21.3%), brain (12.8%) and extremities (9.6%). The symptomatology at diagnosis was variable. Only 6.4% presented with synchronous metastasis. Hypoglycemia (Doege-Potter syndrome) was seen in 2.1% of cases. A resection of the primary SFT was done in 86 pts (91.5%), their disease-free survival was 35.5 mo and 43% stayed SFT-free during follow-up. Local recurrence occurred in 26.7% of cases, associated with a med. overall survival (OS) of 45.1 mo. Metachronous metastasis was seen in 30.2% of pts, occurring after a med. follow-up of 36 mo. Med. OS after diagnosis of metastasis was 19.0 mo. Systemic therapy was given to 92.9% of pts with inoperable/metastatic disease. The most common 1^st line therapy was doxorubicin single agent (57.7% of pts), achieving responses in 13.3% of pts. 2^nd linetherapies included ifosfamide and pazopanib (31.3% of pts each), 3^rd line treatment was very heterogeneous. Conclusion: SFT is an orphan malignancy with a variable clinical course, low incidence of distant spread at first diagnosis but considerable risk of local failure and metachronous metastasis. Surgery is the only curative option at diagnosis, time of relapse and in case of resectable metastasis. Palliative systemic therapy is considered in pts with inoperable/metastatic disease but achieves low response rates. The natural course and survival outcomes of SFT cases treated with palliative intent tends to be better than in non-selected STS pts.