TREATMENT SUMMARY TEMPLATE

Before the clinic visit, the healthcare professional (HCP) prepares a Treatment Summary using the survivor’s medical record, including standardised treatment data, such as treatment start and end dates, chemotherapy drug names and cumulative doses, other drug names and doses, radiotherapy fields and doses, details on stem cell transplantation and surgeries. The treatment data covers treatments for the initial cancer, all recurrences and subsequent tumours (either malignant or benign), if any. As such, it is a living document that can be updated by HCPs over the course of Survivorship Care. At the clinic visit, the Treatment Summary is discussed and shared with the survivor to create awareness and increase their knowledge of their own treatment history, thereby empowering the survivor to take responsibility for their own health.

During development of the Care intervention, a standardised format for the

First page of the Survivorship Care plan template

Treatment Summary was agreed by first reviewing six treatment summary templates currently used in Survivorship Care (from clinics in Linz (Austria), Utrecht (the Netherlands), Leuven (Belgium), Lund (Sweden), Newcastle upon Tyne (United Kingdom)) and the Treatment Summary template used in the digital Survivorship Passport (SurPass, https://www.survivorshippassport.org/) 1 used by six clinics of the Italian Association of Paediatric Haematology and Oncology (AIEOP) (Italy) 2. Only the Dutch and the SurPass Treatment Summary templates included a database with a standard list of variables that could be used to electronically generate a survivor’s Treatment Summary, whereas the other templates could only be completed manually. Both the Dutch and Italian templates could also be completed manually, if required.

As the Care intervention was delivered in the cohort study in Italy using the SurPass, the variable list for the SurPass Treatment Summary was used as a starting point and compared to the other identified Treatment Summary templates. Following an extensive evaluation and consensus process, a final Treatment Summary template was agreed in English and then translated to Dutch, Czech and Swedish. 3 Minor modifications to the SurPass (in Italian) were implemented to align with the final Treatment Summary template.

The Treatment Summary template is provided below in English. Treatment Summary templates in Czech, Dutch and Swedish are available upon request through PanCare (info@pancare.eu).

Delivering the Care Intervention via the Survivorship Passport (SurPass)

The digital Survivorship Passport (SurPass, https://www.survivorshippassport.org/) is an innovative tool that was used to deliver the Care intervention in Italy, including the Treatment Summary and Survivorship Care Plan. In PanCareFollowUp, generation of the recommendations for discussion with the survivor at the clinic visit was automated, significantly reducing the time required to prepare the preliminary Survivorship Care Plan. Data for the Treatment Summary was entered manually from medical records, which was a time-consuming procedure, but semi-automation of data entry is being pursued to make this process quicker in a follow-on project, PanCareSurPass. PanCareSurPass is developing SurPass v2.0 with (semi-) automated data transfer using HL7 FHIR standards, and versions available in Dutch, German, Italian, Lithuanian and Spanish. At present, it is not possible to implement the Care intervention via the SurPass outside of Italy using only the materials in this manual. However, interested clinics or health systems can contact PanCare (info@pancare.eu) for more information on how to proceed if they are interested in using the SurPass.

Disclaimer

PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

1 Haupt R, et al. The ‘Survivorship Passport’ for childhood cancer survivors. Eur J Cancer. 2018;102:69-81.

2 The SurPass was developed as part of previous European Union projects (e.g. European Network for Cancer Research in Children and Adolescents and PanCareSurFup). Its comprehensive variable list was used as a starting point and compared with the other treatment summaries to develop a draft Treatment Summary template for PanCareFollowUp.

3 van Kalsbeek RJ, et al. The PanCareFollowUp Care Intervention: A European harmonised approach to person-centred guideline-based survivorship care after childhood, adolescent and young adult cancer. European journal of cancer 2022;162:34-44.