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Bultijnck R, Van Hemelrijck M, Fonteyne V, Livi L, Jereczek-Fossa BA, Hemmatazad H, Mayinger M, Peulen H, Verbeke L, Ramella S, Castro P, Tsoutsou P, Stellamans K, Shaukat A, Orazem M, Jeene P, Braam P, Verkooijen H, Simek IM, Alongi F, Clementel E, Fortpied C, Machingura A, Boakye Oppong F, Guckenberger M, Ost P. Health-related quality of life in men with oligometastatic prostate cancer following metastases-directed stereotactic body radiotherapy: Real-world data from the E 2-RADIatE OligoCare cohort. Clin Transl Radiat Oncol 2024; 45:100715. [PMID: 38274388 PMCID: PMC10808936 DOI: 10.1016/j.ctro.2023.100715] [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: 10/03/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
Objective To evaluate the impact of metastases-directed stereotactic body radiotherapy (SBRT) on health-related quality of life (HRQoL) in men with oligometastatic prostate cancer (PCa) using real-world data from the OligoCare cohort. Materials and methods OligoCare is a pragmatic, observational cohort designed to assess the impact of metastases-directed SBRT on patients with oligometastatic disease (OMD). We report an interim analyses of the secondary endpoint HRQoL, assessed using the EORTC QLQ-C30, within six months of metastases-directed SBRT for oligometastatic disease in men with PCa among the first 1600 registered patients. HRQoL data collection was optional within the OligoCare cohort. To compare HRQoL between baseline and first follow-up assessment, a Wilcoxon signed-rank test was used. A multiple linear regression model was used to explore the HRQoL associations with predefined factors. Results Out of the 1600 registered patients, 658 were treated for oligometastatic PCa, of which 233 had baseline QoL data and 132 patients had both baseline and follow-up HRQoL data. At baseline, most patients had a WHO performance status of 0 or 1 (87 %), were de-novo oligometastatic (79 %), had one metastasis (90 %), and had a good overall global health status (mean 80.81, SD16.11, IQR 75-92). 51 % received hormonal therapy as concomitant systemic treatment. Patients with comorbidities as assessed by the Charlson Comorbidity index had a worse global health status at baseline (-4.88, 95 % CI:-9.35, -0.42). No clinically meaningful significant difference in global health status was observed at first assessment following SBRT (median 3.0 months) compared with baseline (mean difference 2.27, 95 % CI:-1.54, 6.08). Upon evaluating the proportions, meaningful clinically important differences (a 10-point or more difference) was observed in, 17 % and 11 % of the patients reporting deterioration and improvement of global health status, respectively. Conclusion Metastases-directed stereotactic body radiotherapy had no negative impact on global HRQoL within the first six months after treatment.
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Affiliation(s)
- Renée Bultijnck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Studies, Translational Oncology and Urology Research (TOUR), King's College London, London, UK
| | - Valérie Fonteyne
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Lorenzo Livi
- Department of Experimental and Clinical Biomedical Sciences M Serio, University of Florence, Florence, Italy
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Barbara Alicja Jereczek-Fossa
- Dept. of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Dept. of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Hossein Hemmatazad
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Switzerland
| | - Michael Mayinger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Heike Peulen
- Catharina Ziekenhuis, Radiation Oncology, Eindhoven, the Netherlands
| | - Luc Verbeke
- Onze-Lieve-Vrouw Ziekenhuis, Radiation Oncology, Aalst, Belgium
| | - Sara Ramella
- Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
- Research Unit of Radiation Oncology, Department of Medicine and Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Pablo Castro
- Health Research Institute Hospital Universitario de La Princesa
| | - Pelagia Tsoutsou
- Hôpitaux universitaires de Genève - HUG - site de Cluse-Roseraie, Genève, Switzerland
| | | | - Adnan Shaukat
- NHS Grampian - Aberdeen Royal Infirmary, Aberdeen, Scotland
| | - Miha Orazem
- Institute of Oncology, Division of Radiation Oncology, Ljubljana, Slovenia and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Paul Jeene
- Radiotherapiegroep, Deventer, the Netherlands
| | - Pètra Braam
- Radboud University Medical Center Nijmegen, Radiation Oncology, Nijmegen, the Netherlands
| | | | - Inga-Malin Simek
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria
| | - Filippo Alongi
- IRCCS Sacro Cuore Don Calabria Hospital & University of Brescia, Radiation Oncology, Verona, Italy
| | - Enrico Clementel
- European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium
| | - Catherine Fortpied
- European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium
| | - Abigirl Machingura
- European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium
| | - Felix Boakye Oppong
- European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Piet Ost
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Iridium Network, Radiation Oncology, Wilrijk, Belgium
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Wasalski E, Mehta S. Health-Related Quality of Life Data in Cancer Clinical Trials for Drug Registration: The Value Beyond Reimbursement. JCO Clin Cancer Inform 2021; 5:112-124. [PMID: 33492993 DOI: 10.1200/cci.20.00100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE A review of the literature was performed to evaluate how quality of life measures are collected, analyzed, and reported in cancer clinical trials intended to support drug registration.Health-related quality of life (HRQoL) data points are one of the patient-reported outcome (PRO) assessments used in clinical trials to evaluate the effects of treatments from the patient perspective. The use of PROs has gained focus in cancer clinical trials as more options become available for greater longevity of patients on treatment. Standardization of PRO data is evolving and involves unique challenges when used for assessing biologic and chemotherapeutic agents for the treatment of cancer. METHODS In this study, a review of literature published between 2009 and 2019 was conducted using PubMed, COCHRANE Library, and Medline. The research focus was on the current guidance, implementation, and reporting as well as highlighting the issues, and recommendations for the inclusion of HRQoL end points in cancer clinical trials intended for use in drug registration. RESULTS Although there exist many levels of guidance for HRQoL measures in cancer drug trials, challenges to operational implementation, the current inconsistent adherence to reporting standards, and the lack of consensus and understanding of analyses limit the value and potential of the resulting data collected. CONCLUSION The results of HRQoL data collected from cancer clinical trials can be difficult to interpret and apply to inform clinical decision making. Increased reporting and access to these data can provide opportunities for potential applications to improve translatability of HRQoL data collected in clinical trials into practice.
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Affiliation(s)
- Erinne Wasalski
- Rutgers The State University of New Jersey, School of Health Professions, Department of Interdisciplinary Studies, 65 Bergen Street, Newark, NJ 07107-1709
| | - Shashi Mehta
- Rutgers The State University of New Jersey, School of Health Professions, Department of Clinical Laboratory and Medical Imaging Sciences, 65 Bergen Street, Newark, NJ 07107-1709
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Pratt-Chapman M, Bhadelia A. Patient-Reported Outcomes in Health Economic Decision-Making: A Changing Landscape in Oncology. Recent Results Cancer Res 2019; 213:67-83. [PMID: 30543008 DOI: 10.1007/978-3-030-01207-6_6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cancer causes significant death and disability globally. However, costs of more personalized cancer care continue to climb, while access to basic cancer screening and treatment is not available to much of the world. This chapter provides an overview of the status of patient-reported outcomes (PROs) in cancer clinical care and research. PROs are valuable for health care and health economic decision-making at institutional, regional, national, and international levels. PRO data should be considered along with cost and survival data when approving new therapies. PRO data can also be helpful when assessing existing treatment options for patients, particularly for drugs with minor outcome and toxicity differences. Finally, PROs can be useful in reimbursement algorithms to ensure delivery of quality cancer care in value-based financing environments. The authors advocate for reframing the concept of health value, aligning PRO measures with societal values, and broadening the definition of society to extend beyond national boundaries.
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Affiliation(s)
| | - Afsan Bhadelia
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Johns Hopkins School of Public Health, Baltimore, MD, USA
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