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Brown A, Yim J, Jones S, Tan A, Callander E, Watt K, De Abreu Lourenco R, Pain T. Men's perceptions and preferences regarding prostate cancer radiation therapy: A systematic scoping review. Clin Transl Radiat Oncol 2022; 38:28-42. [PMID: 36345391 PMCID: PMC9636414 DOI: 10.1016/j.ctro.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To assess the literature on men's preferences and perceptions regarding prostate cancer radiation therapy. METHODS A scoping review was undertaken as per JBI guidelines. Searches were conducted in PubMed, CINAHL, Scopus and Science Direct with search terms including "prostate cancer," "radiotherapy," "radiation therapy," "radiation oncology," "patient preferences," "patient perceptions" and "patient experience." The resultant studies were mapped and grouped according to the emergent themes and pathway stages. RESULTS A total of 779 titles and abstracts were screened by two independent reviewers. Fifty-two full-text studies were reviewed, with 27 eligible for inclusion. There were 4 pre-treatment, 13 during treatment and 10 post-treatment studies covering broad themes of information needs (n = 3), preferences and decisions (n = 6), general experiences (n = 8), side effects (n = 6), and support (n = 4). There were a mix of methodologies, including 11 qualitative, 14 quantitative (including four preference studies), one mixed methods and one narrative review. CONCLUSION There were only four preference studies, with the remaining 23 reporting on perceptions. Overall, there is a paucity of literature regarding patient preferences and perceptions of prostate cancer radiation therapy, particularly when considering how many clinical and technical studies are published in the area. This highlights opportunities for future research.
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Affiliation(s)
- Amy Brown
- Townsville University Hospital, Townsville, Queensland, Australia,James Cook University, Townsville, Queensland, Australia,Corresponding author at: Townsville University Hospital, PO Box 670, Queensland 4815, Australia.
| | - Jackie Yim
- Department of Radiation Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia,Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Scott Jones
- Radiation Oncology Princess Alexandra Hospital Raymond Terrace, Metro South Health Service, South Brisbane, Queensland, Australia
| | - Alex Tan
- James Cook University, Townsville, Queensland, Australia,Radiation Oncology, Genesis Cancer Care, Nambour, Queensland, Australia
| | | | - Kerrianne Watt
- James Cook University, Townsville, Queensland, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Tilley Pain
- Townsville University Hospital, Townsville, Queensland, Australia,James Cook University, Townsville, Queensland, Australia
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Brown A, Tan A, Anable L, Callander E, De Abreu Lourenco R, Pain T. Perceptions and recall of treatment for prostate cancer: A survey of two populations. Tech Innov Patient Support Radiat Oncol 2022; 24:78-85. [PMID: 36304425 PMCID: PMC9594631 DOI: 10.1016/j.tipsro.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/22/2022] [Accepted: 10/03/2022] [Indexed: 11/14/2022] Open
Abstract
Background The complexity of prostate cancer care can impact on patient understanding and participation in shared decision-making. This study used a survey-based approach to investigate patients' recall of their prostate cancer treatment, and more broadly, to understand the perceptions of patients and the general population of prostate cancer treatment. Method The survey was completed by 236 patients with prostate cancer (PCa cohort) and 240 participants from the general population of Australia (GenPop cohort). Free-text comments from both cohorts were analysed using content analysis. The PCa cohort reported which treatments and image-guidance related procedures they had received. These patient-reports were compared to medical records and analysed using proportion agreement, kappa statistics and regression analysis. Results 135 (57%) PCa and 99 (41%) GenPop respondents provided at least one comment. Five major themes were identified by both cohorts: sharing experiences of treatment; preferences insights and reflections; mindsets; general commentary on the survey; and factors missing from the survey. There was overall good treatment recall amongst the PCa cohort, with proportions of correct recall ranging from 97.3% for chemotherapy to 66.8% for hormone therapy. There was a tendency for younger patients (<70 years old) to recall their hormone treatment more correctly. Conclusion Participant comments suggest the complexity of prostate cancer diagnosis and treatment, and the varying perceptions and experiences of participants with prostate cancer. Patients' recall overall was good for both treatment and image-guidance related procedures/approaches, however the poorer recall of hormone therapy requires further investigation.
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Affiliation(s)
- Amy Brown
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
- Corresponding author at: PO Box 670, Townsville Hospital and Health Service, Queensland 4815, Australia.
| | - Alex Tan
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
| | - Lux Anable
- Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Emily Callander
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
- Monash University, Melbourne, VIC, Australia
| | | | - Tilley Pain
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
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De Silva K, Brown A, Edwards C. Impact of transperineal ultrasound on perineal skin dose in prostate radiation therapy. Tech Innov Patient Support Radiat Oncol 2022; 23:27-32. [PMID: 36090010 PMCID: PMC9460562 DOI: 10.1016/j.tipsro.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction This study investigated the relationship between anatomical compression introduced via ultrasound probe pressure and maximum perineum dose in prostate radiotherapy patients using the Clarity transperineal ultrasound (TPUS) system. Methods 115 patient ultrasound and computed tomography scans were retrospectively analysed. The probe to prostate apex distance (PPA), probe to inferior corpus spongiosum distance (PICS) and maximum perineum dose were calculated. Compression was represented by the PICS and the calculated corpus to prostate ratio (CPR). Demographics included treatment technique, image quality, body mass index (BMI) and age. Multiple linear regression analysis assessed the relationship between compression measures and perineum dose. Results The maximum dose to perineum ranged from 1.81 to 45.56 Gy, with a median of 5.87 Gy (Interquartile range (IQR) 3.17). The PICS distance and CPR recorded was 1.67 cm (IQR 0.63) and 0.51 (range 0.29–0.85) respectively. Regression analysis demonstrated both PICS and CPR were significant predictors of maximum dose to the perineum (p < 0.001). Patient-specific factors, including age, BMI, treatment technique and ultrasound image quality, were not factors that significantly impacted the maximum perineum dose. Conclusion There was a statistically significant association between increased anatomical compression and perineal dose measurements. A PICS of 1.2 cm or greater is recommended, with compression reduced as much as possible without losing anatomical US definition. Future investigations would be beneficial to evaluate the optimal balance between ultrasound image quality and transducer compression considering the perineum dose.
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Affiliation(s)
- Kalani De Silva
- School of Clinical Sciences, Queensland University of Technology, Gardens Point Campus, Brisbane, QLD, Australia
| | - Amy Brown
- Townsville University Hospital, Townsville, Queensland, Australia
- Corresponding author at: Townsville University Hospital, PO Box 670, Townsville, QLD 4810, Australia.
| | - Christopher Edwards
- School of Clinical Sciences, Queensland University of Technology, Gardens Point Campus, Brisbane, QLD, Australia
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Brown A, Jones S, Yim J. Health preference research: An overview for medical radiation sciences. J Med Radiat Sci 2022; 69:394-402. [PMID: 35388630 PMCID: PMC9442284 DOI: 10.1002/jmrs.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/09/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022] Open
Abstract
Understanding preferences of key stakeholders including patients, clinicians and policymakers can inform clinical practice, workforce and policy. It also allows health services to evaluate existing clinical practices, policies and procedures. This commentary aims to introduce medical radiation professionals to health preference research by describing commonly used preference methodologies, with a particular focus on discrete choice experiments. Relevant examples of health preference research will be highlighted to demonstrate the application of health preference research in medical radiation sciences.
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Affiliation(s)
- Amy Brown
- Townsville Cancer Centre, Townsville University Hospital, Townsville, Queensland, Australia
| | - Scott Jones
- Radiation Oncology Princess Alexandra Hospital Raymond Terrace, Metro South Health Service, South Brisbane, Queensland, Australia
| | - Jackie Yim
- Department of Radiation Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Centre for Health Economics Research and Evaluation, Business School, University of Technology Sydney, Sydney, New South Wales, Australia
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Cellini F, Tagliaferri L, Frascino V, Alitto AR, Fionda B, Boldrini L, Romano A, Casà C, Catucci F, Mattiucci GC, Valentini V. Radiation therapy for prostate cancer: What's the best in 2021. Urologia 2022; 89:5-15. [PMID: 34496707 DOI: 10.1177/03915603211042335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Radiotherapy is highly involved in the management of prostate cancer. Its features and potential applications experienced a radical evolution over last decades, as they are associated to the continuous evolution of available technology and current oncological innovations. Some application of radiotherapy like brachytherapy have been recently enriched by innovative features and multidisciplinary dedications. In this report we aim to put some questions regarding the following issues regarding multiple aspects of modern application of radiation oncology: the current application of radiation oncology; the modern role of stereotactic body radiotherapy (SBRT) for both the management of primary lesions and for lymph-nodal recurrence; the management of the oligometastatic presentations; the role of brachytherapy; the aid played by the application of the organ at risk spacer (spacer OAR), fiducial markers, electromagnetic tracking systems and on-line Magnetic Resonance guided radiotherapy (MRgRT), and the role of the new opportunity represented by radiomic analysis.
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Affiliation(s)
- Francesco Cellini
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Luca Tagliaferri
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Vincenzo Frascino
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Anna Rita Alitto
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Bruno Fionda
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Luca Boldrini
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Angela Romano
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Calogero Casà
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | - Gian Carlo Mattiucci
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia
- Radiation Oncology, Mater Olbia Hospital, Olbia, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia
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Brown A, Pain T, Tan A, Anable L, Callander E, Watt K, Street D, De Abreu Lourenco R. Men's preferences for image-guidance in prostate radiation therapy: A discrete choice experiment. Radiother Oncol 2021; 167:49-56. [PMID: 34890737 DOI: 10.1016/j.radonc.2021.11.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION There are several options for real-time prostate monitoring during radiation therapy including fiducial markers (FMs) and transperineal ultrasound (TPUS). However, the patient experience for these procedures is very different. This study aimed to determine patient preferences around various aspects of prostate image-guidance, focusing on FMs and TPUS. METHODS A discrete choice experiment (DCE) was conducted, describing the image-guidance approach by: pain, cost, accuracy, side effects, additional appointments, and additional time. Participants were males with prostate cancer (PCa) and from the general Australian population. A DCE survey required participants to make hypothetical choices in each of 8 choice sets. Multinomial logit modelling and Latent Class Analysis (LCA) were used to analyse the responses. Marginal willingness to pay (mWTP) was calculated. RESULTS 476 respondents completed the survey (236 PCa patients and 240 general population). The most important attributes for both cohorts were pain, cost and accuracy (p < 0.01). PCa patients were willing to pay more to avoid the worst pain than the general population, and willing to pay more for increased accuracy. LCA revealed 3 groups: 2 were focused more on the process-related attributes of pain and cost, and the third was focused on the clinical efficacy attributes of accuracy and side effects. CONCLUSION Both cohorts preferred less cost and pain and improved accuracy, with men with PCa valuing accuracy more than the general population. In addition to the clinical and technical evidence, radiation oncology centres should consider the preferences of patients when considering choice of image-guidance techniques.
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Affiliation(s)
- Amy Brown
- Townsville Hospital and Health Service, Townsville, Australia; James Cook University - Bebegu Yumba Campus, Townsville, Australia.
| | - Tilley Pain
- Townsville Hospital and Health Service, Townsville, Australia; James Cook University - Bebegu Yumba Campus, Townsville, Australia
| | - Alex Tan
- Townsville Hospital and Health Service, Townsville, Australia; James Cook University - Bebegu Yumba Campus, Townsville, Australia
| | - Lux Anable
- Townsville Hospital and Health Service, Townsville, Australia
| | - Emily Callander
- Monash University, Melbourne, Australia; James Cook University - Bebegu Yumba Campus, Townsville, Australia
| | - Kerrianne Watt
- James Cook University - Bebegu Yumba Campus, Townsville, Australia
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Brown A, Pain T, Preston R. Patient perceptions and preferences about prostate fiducial markers and ultrasound motion monitoring procedures in radiation therapy treatment. J Med Radiat Sci 2021; 68:37-43. [PMID: 32997897 PMCID: PMC7890917 DOI: 10.1002/jmrs.438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Patient experiences and preferences of image-guidance procedures in prostate cancer radiotherapy are largely unknown. This study explored experiences and preferences of patients undergoing both fiducial marker (FM) insertion and Clarity ultrasound (US) procedures. METHODS A sequential explanatory mixed method approach was used. A questionnaire (n = 40) ranked experiences from 0 to 10 (worst) in the domains of invasiveness; pain; physical discomfort; and psychological discomfort. Responses were analysed with descriptive and inferential statistics. Semi-structured interviews (n = 22) obtained further insights into their perspectives and preferences and were thematically analysed. RESULTS Perceptions of invasiveness varied with 46% reporting FMs more invasive than US and 49% the same for the two procedures. The mean score for FM was 3.6 and 2.1 for US. Mean scores for pain, physical and psychological discomfort were higher for FMs with 3.3, 3.2 and 2.9, respectively, and 1.1, 1.2 and 1.7 respectively for US, only pain achieved significance (P < 0.05). Three themes emerged from the interviews: Expectations versus Experience; Preferences linked to Priorities; and Motivations. Eleven patients (50%) preferred US; however, 10 (45%) could not illicit a preference. CONCLUSION Participants found both of the FM and US image-guidance procedures tolerable and acceptable. Men's preference was elusive, suggesting a more rigorous preference methodology is required to understand preferences in this population.
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Affiliation(s)
- Amy Brown
- Townsville University HospitalTownsvilleQueenslandAustralia
- James Cook UniversityTownsvilleQueenslandAustralia
| | - Tilley Pain
- Townsville University HospitalTownsvilleQueenslandAustralia
- James Cook UniversityTownsvilleQueenslandAustralia
| | - Robyn Preston
- James Cook UniversityTownsvilleQueenslandAustralia
- Central Queensland UniversityTownsvilleAustralia
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