ePRO-Guided Symptom Management In Breast Cancer Adjuvant Radiotherapy: A Prospective Controlled Study

Postoperative adjuvant radiotherapy for breast cancer is frequently associated with acute treatment-related symptoms that negatively affect quality of life (QoL). This prospective controlled study evaluated the efficacy of an electronic patient-reported outcome (ePRO)-guided symptom management pathway integrated into routine radiotherapy care. A total of 117 patients were enrolled, and 105 completed radiotherapy and were included in the final analysis (usual care, n = 52; usual care plus ePRO-guided management, n = 53). The primary endpoint was the longitudinal trajectory of acute symptom burden, while the secondary endpoint was change in QoL during treatment. Validated symptom and QoL instruments were administered longitudinally, and outcomes were analyzed using linear mixed-effects models adjusted for prespecified baseline covariates. Compared with usual care, the ePRO-guided group demonstrated significantly lower peak symptom severity, faster symptom recovery toward the end of treatment, and more favorable longitudinal trends in global and breast cancer-specific QoL domains (all P < 0.05). The ePRO-guided pathway integrated weekly monitoring, automated alert generation, and nurse-led stratified interventions into a closed-loop management workflow. These findings suggest that integrating ePRO-triggered symptom management into routine radiotherapy practice may reduce acute symptom burden and support patient-centered care during breast cancer radiotherapy.