A text analytics approach for mining public discussions in online cancer forum: Analysis of multi-intent lung cancer treatment dataset

BACKGROUND

Online cancer forums (OCF) are increasingly popular platforms for patients and caregivers to discuss, seek information on, and share opinions about diseases and treatments. This interaction generates a substantial amount of unstructured text data, necessitating deeper exploration. Using time series data, our study exploits topic modeling in the novel domain of online cancer forums (OCFs) to identify meaningful topics and changing dynamics of online discussion across different lung cancer treatment intent groups.

METHODS

For this purpose, a dataset comprising 27,998 forum posts about lung cancer was collected from three OCFs: lungcancer.net, lungevity.org, and reddit.com, spanning the years 2016 to 2018.

RESULTS

The analysis reflects the public discussion on multi-intent lung cancer treatment over time, taking into account seasonal variations. Discussions on cancer symptoms and prevention garnered the most attention, dominating both curative and palliative care discussions. There were distinct seasonal peaks: curative care topics surged from winter to late spring, while palliative care topics peaked from late summer to mid-autumn. Keyword analysis highlighted that lung cancer diagnosis and treatment were primary topics, whereas cancer prevention and treatment outcomes were predominant across multi-care contexts. For the study period, curative care discussions predominantly revolved around informational support and disease syndromes. In contrast, social support and cancer prevention prevailed in the palliative care context. Notably, topics such as cancer screening and cancer treatment exhibit pronounced seasonal variations in curative care, peaking in frequency during the summers (May to August) of the study period. Meanwhile, the topic of tumor control within palliative care showed significant seasonal influence during the winters and summers of 2017 and 2018.

CONCLUSION

Our text analysis approach using OCF data shows potential for computational methods in this novel domain to gain insights into trends in public cancer communication and seasonal variations for a better understanding of improving personalized care, decision support, treatment outcomes, and quality of life.

Effect of oligometastatic disease management with stereotactic body radiation therapy on survival in patients with metastatic lung cancer

e13582

Background: Overall survival (OS) of metastatic non-small cell lung cancer (NSCLC) patients (pts) is improving with the development of targeted therapies (TARGET) and immunotherapy (IMMUNO), however is limited by disease progression (PD) which necessitates a change in systemic therapy. Stereotactic body radiation therapy (SBRT) can allow NSCLC pts to stay longer with the same therapy by eliminating oligometastatic progression (OMP) improving progression free survival (PFS) and OS. Methods: 100 pts with metastatic NSCLC undergoing chemotherapy (CHEMO), IMMUNO or TARGET that had OMP defined as less than 4 sites of metastasis and underwent SBRT were evaluated for PFS and OS. PFS1: Time between initiation of systemic therapy and development of OMP. PFS2: Time between OMP treated with SBRT and development of further PD requiring a change in systemic therapy. Pts received IMMUNO for second line and beyond. Robotic SBRT was delivered in 1-5 fractions on consecutive days or every other day. SBRT doses were determined based on the disease site and dose tolerance of the adjacent organs. Results: Brain metastasis (BM) were seen in 45 pts and 55 pts had extracranial metastasis (EM). 34 pts were receiving CHEMO, 34 Target and 32 IMMUNO at the time of OMP. Main endpoints (m) are shown (Table) Pts with BM that received SBRT were able to continue the same therapy for a period of 6.5-9 extra months due to the control of BM. Pts with EM that have developed PD were able to continue the same therapy 17-21 extra months due to the ablation of OMP by SBRT. Overall PFS was: 16.5m for BM and 34m for EM and the OS were: 31m and 53m respectively. Conclusions: Substantial prolongation was observed in PFS/OS compared with historical controls thanks to the use of SBRT in pts that develop OMP while on systemic therapy. SBRT allowed patients to continue with the same systemic treatment. Our CHEMO cohort is composed of long term survivors under therapy and may not represent the average PFS/OS of pts on CHEMO. Survival data from prospective trials will be essential in determining the value of this resource-intensive treatment.[Table: see text]

Proton therapy coverage for prostate cancer treatment

PURPOSE

To determine the impact of prostate motion on dose coverage in proton therapy.

METHODS AND MATERIALS

A total of 120 prostate positions were analyzed on 10 treatment plans for 10 prostate patients treated using our low-risk proton therapy prostate protocol (University of Florida Proton Therapy Institute 001). Computed tomography and magnetic resonance imaging T(2)-weighted turbo spin-echo scans were registered for all cases. The planning target volume included the prostate with a 5-mm axial and 8-mm superoinferior expansion. The prostate was repositioned using 5- and 10-mm one-dimensional vectors and 10-mm multidimensional vectors (Points A-D). The beam was realigned for the 5- and 10-mm displacements. The prescription dose was 78 Gy equivalent (GE).

RESULTS

The mean percentage of rectum receiving 70 Gy (V(70)) was 7.9%, the bladder V(70) was 14.0%, and the femoral head/neck V(50) was 0.1%, and the mean pelvic dose was 4.6 GE. The percentage of prostate receiving 78 Gy (V(78)) with the 5-mm movements changed by -0.2% (range, 0.006-0.5%, p > 0.7). However, the prostate V(78) after a 10-mm displacement changed significantly (p < 0.003) with different movements: 3.4% (superior), -5.6% (inferior), and -10.2% (posterior). The corresponding minimal doses were also reduced: 4.5 GE, -4.7 GE, and -11.7 GE (p < or = 0.003). For displacement points A-D, the clinical target volume V(78) coverage had a large and significant reduction of 17.4% (range, 13.5-17.4%, p < 0.001) in V(78) coverage of the clinical target volume. The minimal prostate dose was reduced 33% (25.8 GE), on average, for Points A-D. The prostate minimal dose improved from 69.3 GE to 78.2 GE (p < 0.001) with realignment for 10-mm movements.

CONCLUSION

The good dose coverage and low normal doses achieved for the initial plan was maintained with movements of < or = 5 mm. Beam realignment improved coverage for 10-mm displacements.