ASTRO   |   RT Answers

Stepping It Up to Improve RT Outcomes

OhriHeadshot“Why aren’t we using fitness trackers to help keep our patients more active?” wondered radiation oncologist Nitin Ohri, MD, following a conversation with a colleague about her wearable device at a charity spinning event. “She had probably taken more steps than all of her patients combined because she was training for a marathon, but the concept of counting steps to improve the health of patients receiving radiation therapy was something I wanted to pursue immediately,” says Dr. Ohri.

Dr. Ohri and his team at the Montefiore Einstein Center for Cancer Care and Albert Einstein College of Medicine worked quickly to establish a pilot study to test the feasibility of tracking patients’ steps during concurrent chemoradiotherapy for head and neck, lung or gastrointestinal cancers. The results were published earlier this year in the Red Journal, and the analyses suggest that step counts may serve as dynamic predictors of short-term hospitalization risk during chemoradiotherapy (Int J Radiation Oncol Biol Phys, Vol. 97, No. 5, pp. 1061-1065, 2017). Dr. Ohri is pleased with what they learned because “The pilot study indicates that we can use step count as a new vital sign of the health of our patients. I think it will be pretty routine someday to ask patients about how much they walk.”

An active and enterprising researcher, Dr. Ohri wanted to know more and to find out if physical activity could be used as a treatment as well as a vital sign. In 2016, he applied for and was awarded nearly $50,000 from ROI’s Innovative Projects in Radiation Oncology program to conduct a randomized trial to determine if giving patients daily customized step count goals as measured and guided through fitness trackers could improve patients’ ability to tolerate concurrent chemoradiotherapy. “The ROI’s quick turn-around time from application to funding allowed us to be one of the first groups to explore the use of fitness trackers during cancer treatment, which has so much potential for rapid growth,” says Dr. Ohri.

In the study, each patient receives a Garmin Vivofit® activity tracker to wear throughout his or her standard course of chemotherapy and radiotherapy. Patients’ activity data is automatically collected when they pass by one of the Vivohub™ wireless access clients that have been installed at key points in the Cancer Center. Dr. Ohri and his team are giving patients in the experimental arm of the study customized daily step count goals, which are based on the previous day’s performance and displayed on their fitness trackers. The team hopes to show that a simple exercise program can improve outcomes for patients by reducing the number of treatments they miss, decreasing treatment-related toxicities and improving their quality of life.

If the results of the study are positive, implementing a similar program could be an easy and relatively low cost supportive care measure that almost any clinician could incorporate into his or her practice. Dr. Ohri says that his team has received positive responses from patients participating in the study and that “Some of the patients really appreciate the extra level of care that they are getting from having us follow their progress between visits.”

Dr. Ohri is committed to exploring the full potential of using fitness trackers to improve outcomes for cancer patients by using the devices’ connections to social media. “I’m starting a group for cancer patients who are using fitness trackers and can help motivate each other to stay active with everything else they are going through,” says Dr. Ohri. “It is also a potentially scalable way of gathering data from cancer patients around the world.” More information about the group that Dr. Ohri is starting will be shared through ROI’s social media accounts in the future.

Dr. Ohri’s pioneering work that is made possible through the generosity of ROI donors recognizes the promise of using familiar technologies in a new way to enhance the care of radiation therapy patients. For updates on Dr. Ohri’s ongoing trial, be sure to follow ROI on Facebook and Twitter


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