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

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• dc.contributor.author Zamora, Víctor
• dc.contributor.author Garin Boronat, Olatz, 1979-
• dc.contributor.author Suárez, José Francisco
• dc.contributor.author Gutiérrez, Cristina
• dc.contributor.author Guedea, Ferrán
• dc.contributor.author Cabrera, Patricia
• dc.contributor.author Castells Esteve, Manel
• dc.contributor.author Herruzo, Ismael
• dc.contributor.author Fumadó Ciutat, Lluis
• dc.contributor.author Samper, Pilar
• dc.contributor.author Ferrer, Carlos
• dc.contributor.author Regis, Lucas
• dc.contributor.author Pont Acuña, Àngels
• dc.contributor.author Ferrer Forés, Maria Montserrat
• dc.contributor.author Multicentric Spanish Group of Clinically Localized Prostate Cancer
• dc.date.accessioned 2024-10-09T06:25:01Z
• dc.date.available 2024-10-09T06:25:01Z
• dc.date.issued 2023
• dc.description.abstract 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Zamora V, Garin O, Suárez JF, Gutiérrez C, Guedea F, Cabrera P, et al. Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures. Clin Transl Radiat Oncol. 2023 Oct 29;44:100694. DOI: 10.1016/j.ctro.2023.100694
• dc.identifier.doi http://dx.doi.org/10.1016/j.ctro.2023.100694
• dc.identifier.issn 2405-6308
• dc.identifier.uri http://hdl.handle.net/10230/61357
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Clin Transl Radiat Oncol. 2023 Oct 29;44:100694
• dc.rights © 2023 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Active surveillance
• dc.subject.keyword Comparative effectiveness
• dc.subject.keyword IMRT
• dc.subject.keyword Localized prostate cancer
• dc.subject.keyword Patient-reported outcome measures
• dc.subject.keyword Real-time brachytherapy
• dc.subject.keyword Robot-assisted radical prostatectomy
• dc.title Comparative effectiveness of new treatment modalities for localized prostate cancer through patient-reported outcome measures
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion