Patient reported outcomes following radiation therapy in men with prostate cancer : a systematic review of prognostic tool accuracy and validity
A partir d'une revue systématique de la littérature publiée entre juillet 2007 et avril 2016 (22 études), cette étude identifie les outils prédictifs validés et utilisés pour les patients atteints d'un cancer de la prostate traité par radiothérapie, puis compare le niveau de précision de ces outils et détermine leur caractère généralisable
Purpose : Prostate 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 Materials : PubMed 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%.
Results : The 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.
Conclusions : A 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.
International Journal of Radiation Oncology • Biology • Physics , résumé, 2016