University of Oulu

Iivanainen, S., Ravichandra, R., Jekunen, A. et al. ePRO symptom follow-up of colorectal cancer patients receiving oxaliplatin-based adjuvant chemotherapy is feasible and enhances the quality of patient care: a prospective multicenter study. J Cancer Res Clin Oncol 149, 6875–6882 (2023).

ePRO symptom follow-up of colorectal cancer patients receiving oxaliplatin-based adjuvant chemotherapy is feasible and enhances the quality of patient care : a prospective multicenter study

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Author: Iivanainen, Sanna1; Ravichandra, Ravi2; Jekunen, Antti2,3;
Organizations: 1Department of Oncology and Radiotherapy, Oulu University Hospital and MRC Oulu, P.B. 22, 90029 Oulu, Finland
2Department of Oncology and Radiotherapy, Vaasa Central Hospital, Vaasa, Finland
3Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
4Kaiku Health Oy, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2 MB)
Persistent link:
Language: English
Published: Springer Nature, 2023
Publish Date: 2023-10-23


Purpose: Electronic (e) patient-reported outcomes (PROs) have been shown to improve the quality of life and survival in chemotherapy treated advanced cancer patients. We hypothesized that multidimensional ePRO centered approach could improve symptom management, streamline patient flow, and optimize the use of healthcare resources.

Methods: In this multicenter trial (NCT04081558), colorectal cancer (CRC) patients receiving oxaliplatin-based chemotherapy as adjuvant or in the first- or second-line setting in advanced disease were included in the prospective ePRO cohort, while a comparative retrospective cohort was collected from the same institutes. The investigated tool consisted of a weekly e-symptom questionnaire integrated to an urgency algorithm and laboratory value interface, which generated semi-automated decision support for chemotherapy cycle prescription and individualized symptom management.

Results: Recruitment to the ePRO cohort occurred 1/2019–1/2021 (n = 43). The comparator group (n = 194) consisted of patients treated in the same institutes 1–7/2017. The analysis was limited to adjuvant treated (n = 36 and n = 35). The feasibility of the ePRO follow-up was good with 98% reporting easy usage and 86% improved care, while health care personnel valued the easy use and logical workflow. In the ePRO cohort, 42% needed a phone call before planned chemotherapy cycles, while this was 100% in the retrospective cohort (p = 1.4e−8). Peripheral sensory neuropathy was detected significantly earlier with ePRO followed (p = 1e−5) but did not translate to earlier dose reduction, delays, or unplanned therapy termination compared to the retrospective cohort.

Conclusion: The results suggest that the investigated approach is feasible and streamlines workflow. Earlier symptom detection may improve the quality in cancer care.

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Series: Journal of cancer research and clinical oncology
ISSN: 0171-5216
ISSN-E: 1432-1335
ISSN-L: 0171-5216
Volume: 149
Issue: 10
Pages: 6875 - 6882
DOI: 10.1007/s00432-023-04622-4
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: Open Access funding provided by University of Oulu including Oulu University Hospital. Study was funded by Roche Diagnostics. Kaiku Health employees were involved in the data acquiring and analysis.
Dataset Reference: The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.
Copyright information: © The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit