Patient- versus physician-reported outcomes in prostate cancer patients receiving hypofractionated radiotherapy within a randomized controlled trial

Rammant, Elke; Ost, Piet; Swimberghe, Martijn; Vanderstraeten, Barbara; Lumen, Nicolaas; Decaestecker, Karel; Bultijnck, Renée; Meerleer, Gert De; Sarrazyn, Camille; Colman, Roos; Fonteyne, Valérie

doi:10.1007/s00066-018-1395-y

Cited by 42 publications

(37 citation statements)

References 28 publications

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“…Studies varied on the tool of HRQOL assessment and the factors affecting it. Rammant et al 10 demonstrated that there was high under-reporting with the physician -reported outcomes as compared to patient-reported outcomes. All the HRQOL tools used in the studies assessed patient's self-reported outcomes, making their data reliable but partially subjective.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Many studies have focused on the assessment of HRQOL with much focus on the effects of treatment on HRQOL. [10][11][12][13] Radical prostatectomy (RP) and radiotherapy (RT) are the most common therapy options for prostate cancer patients, conventionally used to manage the localized disease. 14 Although patients with advanced disease receiving Androgen Deprivation Therapy (ADT) have been found to have the poorest HRQOL scores, 11 and worse symptom burden when combined with radiotherapy or radical prostatectomy, 15 there is still no consensus on the optimal treatment regimen and knowledge of its long-term effects is limited.…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting health-related quality of life among prostate cancer patients: A systematic review

Odeo

Degu

2020

J Oncol Pharm Pract

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Introduction Prostate cancer is recognized as the leading cause of malignancy-related incidence and mortality in the male population. The treatment regimens have long-term effects detrimental to the patient's quality of life. Hence, this review was aimed to determine the overall HRQOL and its associated among prostate cancer patients. Methods The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The databases searched were PubMed, Embase, Google Scholar and Cumulative Index to the Nursing and Allied Literature (CINAHL), which provided articles that were critically examined, yielding 52 studies that met the inclusion criteria for the systematic review. Results Out of 52 studies, 30 studies reported poor overall HRQOL in various domains after prostate cancer treatment. Contrastingly, 15 studies reported good overall quality of life after treatment. Among the various domains, sexual function was the most grossly affected functional score by the treatment modalities of prostate cancer. Nonetheless, seven studies showed that the absence of a significant change in the overall quality of life after treatment. According to the studies, older age, comorbidities, higher clinical stage, higher Gleason score, greater cancer severity, African American race, impaired mental health, neoadjuvant hormonal therapy and lower level of education were the major poor predictors of HRQOL among prostate cancer patients. Conclusion The overall HRQOL in prostate cancer patients was generally poor in various functional domains after treatment. Among the various domains, sexual function was the most grossly affected functional score by the treatment modalities of prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors affecting health-related quality of life among prostate cancer patients: A systematic review

Odeo

Degu

2020

J Oncol Pharm Pract

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“…There are limitations to comparing our toxicity data with published studies because of its retrospective nature and differences in scoring systems, methods and timings of analyses, frequency of follow up and dose fractionation schedules of LDR-EBRT and HDR-HDR-EBRT [8]. We have also only reported grade 3 toxicities and have not collected patient reported outcomes, which more accurately measure adverse events [35]. A comparison of our results with previously published studies is shown in Table 3.…”

Section: Discussionmentioning

confidence: 96%

A comparison of outcomes for patients with intermediate and high risk prostate cancer treated with low dose rate and high dose rate brachytherapy in combination with external beam radiotherapy

Slevin

Rodda

Bownes

et al. 2020

Clinical and Translational Radiation Oncology

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Low dose rate brachytherapy High dose rate brachytherapy External beam radiotherapy a b s t r a c t Introduction: There is evidence to support use of external beam radiotherapy (EBRT) in combination with both low dose rate brachytherapy (LDR-EBRT) and high dose rate brachytherapy (HDR-EBRT) to treat intermediate and high risk prostate cancer. Methods: Men with intermediate and high risk prostate cancer treated using LDR-EBRT (treated between 1996 and 2007) and HDR-EBRT (treated between 2007 and 2012) were identified from an institutional database. Multivariable analysis was performed to evaluate the relationship between patient, disease and treatment factors with biochemical progression free survival (bPFS).Results: 116 men were treated with LDR-EBRT and 171 were treated with HDR-EBRT. At 5 years, bPFS was estimated to be 90.5% for the LDR-EBRT cohort and 77.6% for the HDR-EBRT cohort. On multivariable analysis, patients treated with HDR-EBRT were more than twice as likely to experience biochemical progression compared with LDR-EBRT (HR 2.33, 95% CI 1.12-4.07). Patients with Gleason 8 disease were more than five times more likely to experience biochemical progression compared with Gleason 6 disease (HR 5.47, 95% CI 1.26-23.64). Cumulative incidence of grade 3 genitourinary and gastrointestinal toxicities for the LDR-EBRT and HDR-EBRT cohorts were 8% versus 4% and 5% versus 1% respectively, although these differences did not reach statistical significance. Conclusion: LDR-EBRT may provide more effective PSA control at 5 years compared with HDR-EBRT. Direct comparison of these treatments through randomised trials are recommended to investigate this hypothesis further.

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“…Third, although we found no significant difference with respect to the incidence of late grade 3 GU and GI toxicities (with 5‐year TFS estimates >95% for both groups), the low event rates suggest that our analyses still may have been underpowered to detect clinically important differences. We posit that our low event rates may have been because of limited follow‐up (maximum, 5 years) and the clinician‐reported nature of our outcomes, which may be more susceptible to underreporting relative to patient‐reported outcomes . Finally, our study does not include patients who were initially planned for PBT but were re‐planned for IMRT after failing to meet rectal dose constraints.…”

Section: Discussionmentioning

confidence: 99%

“…We posit that our low event rates may have been because of limited follow-up (maximum, 5 years) and the clinician-reported nature of our outcomes, which may be more susceptible to underreporting relative to patient-reported outcomes. [60][61][62] Finally, our study does not include patients who were initially planned for PBT but were re-planned for IMRT after failing to meet rectal dose constraints.…”

Section: Limitationsmentioning

confidence: 99%

Comparative toxicity outcomes of proton‐beam therapy versus intensity‐modulated radiotherapy for prostate cancer in the postoperative setting

Santos

Barsky

Hwang

et al. 2019

Cancer

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Background Despite increasing utilization of proton‐beam therapy (PBT) in the postprostatectomy setting, no data exist regarding toxicity outcomes relative to intensity‐modulated radiotherapy (IMRT). The authors compared acute and late genitourinary (GU) and gastrointestinal (GI) toxicity outcomes in patients with prostate cancer (PC) who received treatment with postprostatectomy IMRT versus PBT. Methods With institutional review board approval, patients with PC who received adjuvant or salvage IMRT or PBT (70.2 gray with an endorectal balloon) after prostatectomy from 2009 through 2017 were reviewed. Factors including combined IMRT and PBT and/or concurrent malignancies prompted exclusion. A case‐matched cohort analysis was performed using nearest‐neighbor 3‐to‐1 matching by age and GU/GI disorder history. Logistic and Cox regressions were used to identify univariate and multivariate associations between toxicities and cohort/dosimetric characteristics. Toxicity‐free survival (TFS) was assessed using the Kaplan‐Meier method. Results Three hundred seven men (mean ± SD age, 59.7 ± 6.3 years; IMRT, n = 237; PBT, n = 70) were identified, generating 70 matched pairs. The median follow‐up was 48.6 and 46.1 months for the IMRT and PBT groups, respectively. Although PBT was superior at reducing low‐range (volumes receiving 10% to 40% of the dose, respectively) bladder and rectal doses (all P ≤ .01), treatment modality was not associated with differences in clinician‐reported acute or late GU/GI toxicities (all P ≥ .05). Five‐year grade ≥2 GU and grade ≥1 GI TFS was 61.1% and 73.7% for IMRT, respectively, and 70.7% and 75.3% for PBT, respectively; and 5‐year grade ≥3 GU and GI TFS was >95% for both groups (all P ≥ .05). Conclusions Postprostatectomy PBT minimized low‐range bladder and rectal doses relative to IMRT; however, treatment modality was not associated with clinician‐reported GU/GI toxicities. Future prospective investigation and ongoing follow‐up will determine whether dosimetric differences between IMRT and PBT confer clinically meaningful differences in long‐term outcomes.

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Patient- versus physician-reported outcomes in prostate cancer patients receiving hypofractionated radiotherapy within a randomized controlled trial

Cited by 42 publications

References 28 publications

Factors affecting health-related quality of life among prostate cancer patients: A systematic review

Factors affecting health-related quality of life among prostate cancer patients: A systematic review

A comparison of outcomes for patients with intermediate and high risk prostate cancer treated with low dose rate and high dose rate brachytherapy in combination with external beam radiotherapy

Comparative toxicity outcomes of proton‐beam therapy versus intensity‐modulated radiotherapy for prostate cancer in the postoperative setting

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