Treatment Outcome Clinical Trial
Official title:
A Cross-Sectional Feasibility Study of a Telephonic Questionnaire By Research Nurses For Follow-Up Of Locally Advanced Cervical Cancer Patients With Complete Response To Treatment.
Cross-sectional Feasibility study on all consecutive patients of locally advanced cancer of the cervix or vault treated entirely at Tata Memorial Centre with curative intent radiation or chemoradiation.
Our institution registers on an average 670 cases of cancer cervix in a year and almost 75%
are treated with curative intent, therefore around 500 patients a year would be treated with
curative intent. Assuming that 75% of patients registered in a year would be receiving
treatment at our institute, 375 patients a year would be completing treatment, of whom the
investigator expect 80-85% ,i.e 300 patients to have a complete response. The list of
patients who have completed radio(chemotherapy) in 2015 &2016 can be obtained from the
Radiation Oncology Department records. Patients identified for a follow up visit will be
telephonically contacted between one and two weeks before the planned clinic visit and verbal
telephonic consent taken prior to the nurse-led interview. This study should be able to
accrue 300 patients in 6 months.
Patients of locally advanced cervical cancer or vault cancer who have been treated with
radiotherapy with or without concurrent chemotherapy and have a clinical complete response at
3 months post treatment and are within the first 2 years post treatment completion will be
eligible to participate in this study.
Screening: Patients will be screened from the list of patients treated in the radiotherapy
department over the last 2 years (2015-2016), available from the Radiation Oncology
Information System (ROIS). All patients with a diagnosis of cervical cancer or vault cancer
will be screened using the hospital Electronic Medical Record (EMR) to check stage of
disease, schedule of treatment received, response at 3 months post treatment and expected
date of next follow up.
If patient fulfils all inclusion criteria, she will be called by the research nurse,
approximately 1-2 weeks prior to her expected date of follow up, for a preliminary
conversation and invited to participate in the study.
After verbal telephonic consent is obtained, she will be interviewed by the clinical research
nurse using the format of the prepared proforma (Form A) regarding symptoms suggestive of
disease recurrence as well as treatment induced toxicity. At the end of the interview, the
research nurse records her impression of whether the patient has worrisome symptoms of
disease or not and has symptoms of treatment toxicity or not for which she should visit the
hospital.
When the patient reports to the OPD the next week for scheduled physical follow up, the nurse
completes the consenting process by taking a short written informed consent. The examining
physician then takes a complete history and in addition, performs a physical examination and
any investigations he/she deems necessary. Following this he/she notes down final impression
of disease status and toxicity which are taken as the gold standard (Form B). Each patient
will be interviewed only once during their follow up schedule.
In addition at the physical visit, information regarding the acceptability of nurse-led
telephonic follow-up to the patient and the financial impact of physical follow- up will be
collected using a structured format (Form C).
Study participant drop-out/ Lost-to-follow up: Patients may withdraw their consent at any
point during the telephonic interview or the subsequent follow up visit.
- A patient who does not attend the scheduled follow up visit within 1-2 weeks of the
telephonic interview will be called a second time to remind her of the follow up
appointment and enquire about reasons for non-attendance in the clinic, which will be
recorded. If patient does not report to the clinic within the next 2 weeks, she will be
considered to have dropped out from the study.
- Those patients in whom the interval between telephonic interview and the physician's
assessment is more than 4 weeks, will be considered drop outs and follow up telephone
call will go out to enquire about reasons for non-attendance in the clinic, which will
be recorded.
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