Evaluation of a Multidimensional Assessment Tool to Simultaneously Determine Physical Activity, Nutritional and Quality of Life Status in Cancer Patients - A Prospective Pilot Study at Two Cancer Centers.

PURPOSE: Supportive-care needs in cancer patients are multidimensional and interdependent, yet single instruments fail to capture this complexity. We developed the Resource-Oriented Needs Assessment (RONA), a composite battery integrating validated tools across physical fitness, nutritional status, and quality of life (QoL) to identify patterns of individualized needs. This multicenter pilot study evaluated the applicability of the RONA scoring system in a clinical routine setting.

METHODS

Consecutive patients from two German comprehensive cancer centers were prospectively included. RONA comprised of three domains: Physical status: assessed by handgrip strength, spiroergometry, single leg stance test, and 7-day accelerometry. Nutritional status: assessed by BMI, BIA, mGPS, and PG-SGA. QoL was assessed using MFI-20, FACT/GOG-Ntx, HADS, and EORTC QLQ-C30 questionnaires. In each assessment, measures were scored as 0 (none), 1 (moderate), or 2 (severe) needs based on validated cut-offs of each assessment. Values were aggregated into domain and sum RONA scores. Correlation analyses were performed for individual assessments, domains, and RONA sum score levels.

RESULTS

Between 2022 and 2024, a total of 62 patients (cancer types: GI n = 25; non-GI n = 37) were included. Within each individual assessment, the three-level RONA scoring system correlated strongly with the published validated read-outs (ρ = 0.62 to 1.00). On the domain level, highest correlations were seen for spiroergometry (r=0.88) and accelerometry (ρ = 0.55) for the physical status), BIA (ρ =0.54) and PG-SGA (ρ = 0.64) for the nutritional status, and MFI-20 (ρ = 0.81) and EORTC-QLQ-C30 (ρ = 0.74) for the QoL status. Each domain score correlated with the RONA sum score: physical (ρ = 0.69), nutrition (ρ = 0.59), QoL (ρ = 0.65). Subgroup analyses of GI and non-GI cancer patients showed similar correlation patterns for RONA sum scores and the physical and QoL status domain scores, while in GI cancer patients, nutritional status domain scorings only reached 50% of the correlation strength with the RONA sum score (ρ = 0.39) compared to the non-GI cancer group (ρ = 0.70).

CONCLUSIONS

While final conclusions are hindered by the cohort size and non-independence of sum and individual scorings, this pilot study supports value and usability of RONA as a multidimensional tool to assess complex supportive-care needs in cancer patients. While these data need confirmation in larger prospective trials and more homogenous populations, RONA might be used to guide individualized supportive-care interventions and to facilitate complex needs assessments in clinical studies.