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Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures

PURPOSE: There is scarce comparative effectiveness research on the new treatment modalities for localized prostate cancer. We aim to compare through Patient-Reported Outcome Measures (PROMs) the impact of active surveillance, robot-assisted radical prostatectomy (RARP), intensity-modulated radiother...

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Autores principales: Zamora, Víctor, Garin, Olatz, Suárez, José Francisco, Gutiérrez, Cristina, Guedea, Ferran, Cabrera, Patricia, Castells, Manuel, Herruzo, Ismael, Fumadó, Lluis, Samper, Pilar, Ferrer, Carlos, Regis, Lucas, Pont, Àngels, Ferrer, Montse
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10663757/
https://www.ncbi.nlm.nih.gov/pubmed/38021091
http://dx.doi.org/10.1016/j.ctro.2023.100694
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author Zamora, Víctor
Garin, Olatz
Suárez, José Francisco
Gutiérrez, Cristina
Guedea, Ferran
Cabrera, Patricia
Castells, Manuel
Herruzo, Ismael
Fumadó, Lluis
Samper, Pilar
Ferrer, Carlos
Regis, Lucas
Pont, Àngels
Ferrer, Montse
author_facet Zamora, Víctor
Garin, Olatz
Suárez, José Francisco
Gutiérrez, Cristina
Guedea, Ferran
Cabrera, Patricia
Castells, Manuel
Herruzo, Ismael
Fumadó, Lluis
Samper, Pilar
Ferrer, Carlos
Regis, Lucas
Pont, Àngels
Ferrer, Montse
author_sort Zamora, Víctor
collection PubMed
description PURPOSE: There is scarce comparative effectiveness research on the new treatment modalities for localized prostate cancer. We aim to compare through Patient-Reported Outcome Measures (PROMs) the impact of active surveillance, robot-assisted radical prostatectomy (RARP), intensity-modulated radiotherapy (IMRT), and real-time brachytherapy, considering side effects (incontinence, irritative/obstructive urinary symptoms, sexual dysfunction and bowel symptoms) and physical and mental health. MATERIALS AND METHODS: Prospective cohort of men diagnosed with clinically localized prostate cancer (age 50-75y, T1-T2, and low risk including Gleason 3 + 4 in T1c) from 18 Spanish hospitals, followed up to 24 months. Treatment decisions were jointly made by patients and physicians (n = 572). The Expanded Prostate cancer Index Composite (EPIC-26) and Short-Form 36 (SF-36v2) were administered through telephone interviews before and three, six, 12, and 24 months after treatment. To account for correlation among repeated measures, generalized estimating equation models were constructed. All analyses were performed with propensity score weights to solve treatment selection bias. RESULTS: The PROMs completion rate at 24 months was 95.0 %. Active surveillance entails the fewest side effects, but with significant sexual (0.4 standard deviations [SD], p < 0.001) and physical health deterioration (0.5 SD, p < 0.001); and moderate mental health improvement (0.4 SD, p = 0.001) at 24 months. Compared with active surveillance, RARP presented greater urinary incontinence (p = 0.030), and IMRT and real-time brachytherapy worse bowel symptoms (p = 0.027 and p = 0.007) at 24 months. CONCLUSIONS: Most side effects of the new treatment modalities seem to be limited to short-term deteriorations, except for moderate-large urinary incontinence in patients who had undergone RARP and moderate bowel deterioration in patients treated with IMRT or with real-time brachytherapy. Furthermore, patients under active surveillance, IMRT, and real-time brachytherapy showed a moderate improvement in mental health.
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spelling pubmed-106637572023-10-29 Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures Zamora, Víctor Garin, Olatz Suárez, José Francisco Gutiérrez, Cristina Guedea, Ferran Cabrera, Patricia Castells, Manuel Herruzo, Ismael Fumadó, Lluis Samper, Pilar Ferrer, Carlos Regis, Lucas Pont, Àngels Ferrer, Montse Clin Transl Radiat Oncol Original Research Article PURPOSE: There is scarce comparative effectiveness research on the new treatment modalities for localized prostate cancer. We aim to compare through Patient-Reported Outcome Measures (PROMs) the impact of active surveillance, robot-assisted radical prostatectomy (RARP), intensity-modulated radiotherapy (IMRT), and real-time brachytherapy, considering side effects (incontinence, irritative/obstructive urinary symptoms, sexual dysfunction and bowel symptoms) and physical and mental health. MATERIALS AND METHODS: Prospective cohort of men diagnosed with clinically localized prostate cancer (age 50-75y, T1-T2, and low risk including Gleason 3 + 4 in T1c) from 18 Spanish hospitals, followed up to 24 months. Treatment decisions were jointly made by patients and physicians (n = 572). The Expanded Prostate cancer Index Composite (EPIC-26) and Short-Form 36 (SF-36v2) were administered through telephone interviews before and three, six, 12, and 24 months after treatment. To account for correlation among repeated measures, generalized estimating equation models were constructed. All analyses were performed with propensity score weights to solve treatment selection bias. RESULTS: The PROMs completion rate at 24 months was 95.0 %. Active surveillance entails the fewest side effects, but with significant sexual (0.4 standard deviations [SD], p < 0.001) and physical health deterioration (0.5 SD, p < 0.001); and moderate mental health improvement (0.4 SD, p = 0.001) at 24 months. Compared with active surveillance, RARP presented greater urinary incontinence (p = 0.030), and IMRT and real-time brachytherapy worse bowel symptoms (p = 0.027 and p = 0.007) at 24 months. CONCLUSIONS: Most side effects of the new treatment modalities seem to be limited to short-term deteriorations, except for moderate-large urinary incontinence in patients who had undergone RARP and moderate bowel deterioration in patients treated with IMRT or with real-time brachytherapy. Furthermore, patients under active surveillance, IMRT, and real-time brachytherapy showed a moderate improvement in mental health. Elsevier 2023-10-29 /pmc/articles/PMC10663757/ /pubmed/38021091 http://dx.doi.org/10.1016/j.ctro.2023.100694 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Zamora, Víctor
Garin, Olatz
Suárez, José Francisco
Gutiérrez, Cristina
Guedea, Ferran
Cabrera, Patricia
Castells, Manuel
Herruzo, Ismael
Fumadó, Lluis
Samper, Pilar
Ferrer, Carlos
Regis, Lucas
Pont, Àngels
Ferrer, Montse
Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
title Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
title_full Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
title_fullStr Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
title_full_unstemmed Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
title_short Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
title_sort comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10663757/
https://www.ncbi.nlm.nih.gov/pubmed/38021091
http://dx.doi.org/10.1016/j.ctro.2023.100694
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