Prospective evaluation of patient-reported outcomes of invisible ink tattoos for the delivery of external beam radiation therapy: The PREFER trial Journal Article
| Authors: | Hardy-Abeloos, C.; Gorovets, D.; Lewis, A.; Ji, W.; Lozano, A.; Tung, C. C.; Yu, F.; Hanlon, A.; Lin, H.; Kha, A.; Yamada, Y.; Kabarriti, R.; Lazarev, S.; Hasan, S.; Chhabra, A. M.; Simone, C. B. 2nd; Choi, J. I. |
| Article Title: | Prospective evaluation of patient-reported outcomes of invisible ink tattoos for the delivery of external beam radiation therapy: The PREFER trial |
| Abstract: | Introduction: Invisible ink tattoos (IITs) avoid cosmetic permanence of visible ink tattoos (VITs) while serving as more reliable landmarks for radiation setup than tattooless setups. This trial evaluated patient-reported preference and feasibility of IIT implementation. Methods and materials: In an IRB-approved, single institution, prospective trial, patients receiving proton therapy underwent IIT-based treatment setup. A survey tool assessed patient preference on tattoos using a Likert scale. Matched patients treated using our institutional standard tattooless setup were identified; treatment times and image guidance requirements were evaluated between tattooless and IIT-based alignment approaches. Distribution differences were estimated using Wilcoxon rank-sum tests or Chi-square tests. Results: Of 94 eligible patients enrolled, median age was 58 years, and 58.5% were female. Most common treatment sites were breast (18.1%), lung (17.0%) and pelvic (14.9%). Patients preferred to receive IITs versus VITs (79.8% pre-treatment and 75.5% post-treatment, respectively). Patients were willing to travel farther from home to avoid VITs versus IITs (p<0.01). Females were willing to travel (45.5% vs. 23.1%; p=0.04) and pay additional money to avoid VITs (34.5% vs. 5.1%; p<0.01). Per-fraction average +treatment time and time from on table/in room to first beam were shorter with IIT-based vs. tattooless setup (12.3min vs. 14.1min; p=0.04 and 24.1min vs. 26.2min; p=0.02, respectively). Discussion: In the largest prospective trial on IIT-based radiotherapy setup to date, we found that patients prefer IITs to VITs. Additionally, IIT-based alignment is an effective and efficient strategy in comparison with tattooless setup. Standard incorporation of IITs for patient setup should be strongly considered. Copyright © 2024 Hardy-Abeloos, Gorovets, Lewis, Ji, Lozano, Tung, Yu, Hanlon, Lin, Kha, Yamada, Kabarriti, Lazarev, Hasan, Chhabra, Simone and Choi. |
| Keywords: | adult; controlled study; aged; major clinical study; pelvis; prospective study; quality of life; computer assisted tomography; skin pigmentation; breast; clinical assessment; alcohol; lung; radiation therapy; external beam radiotherapy; emotional stress; x ray; tattoo; proton therapy; patient-reported outcome; image guided radiotherapy; human; male; female; article; likert scale; emotional well-being; radiation tattoos; invisible ink tattoo; visible ink tattoo |
| Journal Title: | Frontiers in Oncology |
| Volume: | 14 |
| ISSN: | 2234-943X |
| Publisher: | Frontiers Media S.A. |
| Date Published: | 2024-03-25 |
| Start Page: | 1374258 |
| Language: | English |
| DOI: | 10.3389/fonc.2024.1374258 |
| PROVIDER: | scopus |
| PMCID: | PMC10999588 |
| PUBMED: | 38590650 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is J. Isabelle Choi -- Source: Scopus |
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