Patient reported outcomes following radiation therapy in men with prostate cancer: a systematic review of prognostic tool accuracy and validity

Publication date: Available online 21 February 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Michael E. O'Callaghan, Elspeth Raymond, Jared M. Campbell, Andrew D. Vincent, Kerri Beckmann, David Roder, Sue Evans, John McNeil, Jeremy Millar, John Zalcberg, Martin Borg, Kim Moretti
PurposeProstate cancer is often treated with radiation therapy which can result in a range of toxicities. The accurate assessment of the likelihood of a patient experiencing these toxicities is important for their counselling. This systematic review aimed to identify all validated tools used for the prediction of patient reported outcome measures (PROMs) in patients being treated with radiation therapy for prostate cancer and provide a comparative summary of accuracy and generalisability.Methods and MaterialsPubMed and EMBASE were searched from July 2007. Title/abstract screening, full text review and critical appraisal were undertaken by two reviewers while data extraction was performed by a single reviewer. Eligible papers had to provide a summary measure of accuracy and undertake internal or external validation. Tools were recommended for clinical implementation if they had been externally validated and found to have accuracy ≥70%.ResultsThe search strategy identified 3,839 potential studies, of which 236 progressed to full text review and 22 were included. From these studies 50 tools predicted gastrointestinal/rectal symptoms, 29 tools predicted genitourinary symptoms, four tools predicted erectile dysfunction and no tools predicted quality of life. For patients treated with EBRT three tools could be recommended for the predication of rectal toxicity, gastrointestinal toxicity, and erectile dysfunction. For patients treated with brachytherapy two tools could be recommended for the prediction of urinary retention and erectile dysfunction.ConclusionsA large number of tools for the prediction of PROMs in prostate cancer patients treated with radiation therapy have been developed. Only a small minority are accurate and have been shown to be generalisable through external validation. This review provides an accessible catalogue of tools that are ready for clinical implementation as well as which should be prioritised for validation.

Teaser

This systematic review identified a large number of tools for the prognosis of patient reported outcomes in men undergoing radiation therapy for prostate cancer. However, only minority are accurate and have been shown to be generalisable through external validation. Recommendations are made as to which tools are ready for clinical implementation and which should be prioritised for further validation.


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