gms | German Medical Science

Objective: After a positive randomized clinical trial showing significant survival benefits, Tumor Treating Fields (TTFields) have been implemented in the management of newly diagnosed glioblastoma (GBM). However, this treatment critically depends on patient’s motivation for this therapy plus a high compliance rate. Hair shaving, skin care, application of the arrays and carrying the power source in daily life requires an adequate level of commitment from the patients and their relatives. Based on our clinical experience, it became evident that structure and didactics of the initial and follow up consultations profoundly influence these parameters.

Methods: In the primary time segment of 4 months after publication of the EF-14 trial results, we have informed our patients during inpatient stay shortly after resection and histological diagnosis about this treatment option. After initially unsatisfactory experiences regarding patient motivation for TTFields treatment, we have initiated a designated outpatient clinic for TTFields therapy consultation in analogy to consultation for radiation and chemotherapy. In this setting, we allow about one hour for each patient appointment to meet the need for information about mode of action, clinical efficacy, compliance aspects as well as practical issues with the device application. We developed a standardized patient education concept for intense and open communication about the disease, prognosis and treatment options with advantages and drawbacks.

Results: Using the initial consultation strategy, we were unable to motivate any patients with newly diagnosed GBM to get TTFields treatment. In contrast, after changing the setting into a more patient – centered approach, and standardization of the consultation didactics, 68% of all newly diagnosed patients agreed to apply TTFields therapy. In addition, the average compliance rate was well above 90%, which ensures clinical efficacy of this treatment modality.

Conclusion: Motivation for and compliance to TTFields therapy may critically depend on the consultation setting and strategy.