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Current Oncology
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Patient-Reported Outcome Use in Radiation Oncology Research and Routine Clinical...
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Patient-Reported Outcome Use in Radiation Oncology Research and Routine Clinical Care

A special issue of Current Oncology (ISSN 1718-7729).

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 13182

Special Issue Editor

Prof. Dr. Robert Anton Olson

E-Mail Website
Guest Editor
Department Head/Radiation Oncologist, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
Interests: patient-reported outcomes; stereotactic ablative radiotherapy (SABR); metastatic cancer

Special Issue Information

Dear Colleagues,

Patient-reported outcomes (PROs) are an increasingly recognized outcome measure in oncology, both in routine clinical practice and research. The radiation oncology community has begun to embrace PROs more widely, though adoption is limited by a lack of radiation oncology specific questionnaires, lack of dedicated infrastructure and funding, and limited coordination of questionnaire selection between jurisdictions. In this issue, we will highlight the rationale for using PROs and the development and selection of measures appropriate for radiation oncology practice and research, while highlighting future directions and initiatives underway to coordinate national and international PRO use.

Prof. Dr. Robert Anton Olson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • patient-reported outcomes
  • patient-reported experience measures
  • quality of life
  • toxicity
  • radiation oncology
  • radiotherapy
  • stereotactic ablative radiotherapy (SABR)

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Published Papers (5 papers)

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Research

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12 pages, 1304 KiB  
Article
Using a Weekly Patient-Reported Outcome Questionnaire to Track Acute Toxicity in Patients Undergoing Pelvic Radiotherapy for Gynecologic Cancers
by Matthew Chan, Robert Olson, Vincent Lapointe, Jeremy Hamm, Francois Bachand, Caroline Holloway, Christina Parsons and Peter Lim
Curr. Oncol. 2022, 29(5), 3306-3317; https://doi.org/10.3390/curroncol29050270 - 5 May 2022
Cited by 2 | Viewed by 1881
Abstract
There are limited patient-reported outcome (PRO) data tracking changes in toxicity in patients actively undergoing radiotherapy. Between 2015–2019, acute toxicity was prospectively measured in 698 patients undergoing a 5-week course of pelvic radiotherapy for gynecologic cancers using a weekly PRO questionnaire. Our questionnaire [...] Read more.
There are limited patient-reported outcome (PRO) data tracking changes in toxicity in patients actively undergoing radiotherapy. Between 2015–2019, acute toxicity was prospectively measured in 698 patients undergoing a 5-week course of pelvic radiotherapy for gynecologic cancers using a weekly PRO questionnaire. Our questionnaire was able detect a pattern of onset and resolution of acute gastrointestinal (GI) and genitourinary (GU) toxicity in 27 out of 32 questions. Logistic regression analysis showed that increasing GI and GU toxicity at week 2 could predict for severe toxicity at week 5. However, due to a low number of severe events, univariate results could not be productively added to a multivariate model. We observed a >70% response rate for all sections of the questionnaire, except for questions on sexual and vaginal health, which had a 13% average response rate. By demonstrating that PRO data can be used to track acute toxicity during radiotherapy, there is a need to further examine how this tool may be implemented in the clinic to provide complex, adaptive care, such as early side effect management, and modifying radiation delivery in real-time. Full article
(This article belongs to the Special Issue Patient-Reported Outcome Use in Radiation Oncology Research and Routine Clinical Care)
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11 pages, 1952 KiB  
Article
Patient-Reported Outcomes Measurement in Radiation Oncology: Interpretation of Individual Scores and Change over Time in Clinical Practice
by Jae-Yung Kwon, Lara Russell, Theresa Coles, Robert J. Klaassen, Kara Schick-Makaroff, Kathryn M. Sibley, Sandra A. Mitchell and Richard Sawatzky
Curr. Oncol. 2022, 29(5), 3093-3103; https://doi.org/10.3390/curroncol29050251 - 27 Apr 2022
Cited by 4 | Viewed by 2405
Abstract
Tools for measuring patients’ perceived health and quality of life, such as patient-reported outcome measures (PROMs), inform clinical decisions for patients requiring radiation therapy. However, there may be inconsistencies in how patients interpret and respond to PROMs due to cultural, environmental, personal, or [...] Read more.
Tools for measuring patients’ perceived health and quality of life, such as patient-reported outcome measures (PROMs), inform clinical decisions for patients requiring radiation therapy. However, there may be inconsistencies in how patients interpret and respond to PROMs due to cultural, environmental, personal, or experiential factors. Differential item functioning (DIF) and response shift (RS) refer to differences in the meaning of PROMs between patients or over time (respectively). DIF and RS can threaten the accurate interpretation and use of PROMs, potentially resulting in erroneous conclusions about effectiveness, and flawed individual-level clinical decision-making. Given the empirical evidence of DIF and RS, we aim to review clinical implications and solutions for addressing DIF and RS by providing vignettes from collaborative examinations with workshop participants, as well as the literature. By making these methodological concepts accessible and relevant, for practice, clinicians may feel more confident to ask clarifying questions of patients when PROM scores and the contextual patient information do not align. PROM scores need to be interpreted via dialogue with the patient to avoid misinterpretation due to DIF and RS, which could diminish patient–clinician communication and impede shared decision-making. This work is part of an interdisciplinary knowledge translation initiative focused on the interpretation of PROM scores by clinically-oriented audiences. Full article
(This article belongs to the Special Issue Patient-Reported Outcome Use in Radiation Oncology Research and Routine Clinical Care)
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10 pages, 663 KiB  
Article
Validation of the BC-Brain Patient-Reported Outcome Questionnaire for Patients with Central Nervous System Tumours Treated with Radiotherapy
by Ling Yan, Alan Nichol and Robert Olson
Curr. Oncol. 2022, 29(4), 2798-2807; https://doi.org/10.3390/curroncol29040228 - 16 Apr 2022
Viewed by 2205
Abstract
The BC-brain questionnaire was developed by BC Cancer to detect health problems in patients with central nervous system (CNS) tumours in routine clinical care, treated with radiotherapy (RT), as part of the Prospective Outcomes and Support Initiative (POSI). This study aimed to present [...] Read more.
The BC-brain questionnaire was developed by BC Cancer to detect health problems in patients with central nervous system (CNS) tumours in routine clinical care, treated with radiotherapy (RT), as part of the Prospective Outcomes and Support Initiative (POSI). This study aimed to present and validate the BC-brain questionnaire in patients with brain metastases (BrM) treated with RT. The BC-brain questionnaire was constructed with three subscales: mobility, thinking and CNS symptoms. Patients with BrM from five BC Cancer centres completed this questionnaire at first visit and subsequent follow-up appointments. A total of 365 patients finished the first and 105 finished the follow-up questionnaire. Summary scores of each subscale were calculated. Mobility, thinking and subtotal score showed good reliability with Cronbach’s α > 0.7. Multitrait scaling analysis showed good convergent and divergent validity. The correlations between subscales ranged from 0.262 to 0.456 for baseline and from 0.378 to 0.597 for follow-up. Patients on dexamethasone had worse performance. Patients with a KPS of </=70 had worse performance than patients with a KPS of >70. In general, this BC-brain questionnaire has good reliability and validity, and is proper to use as an option for a patient-reported outcome (PRO) instrument to measure the quality of life in BrM patients treated with RT. Full article
(This article belongs to the Special Issue Patient-Reported Outcome Use in Radiation Oncology Research and Routine Clinical Care)
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8 pages, 358 KiB  
Communication
Evaluation of Patient-Reported Outcome Differences by Radiotherapy Techniques for Bone Metastases in A Population-Based Healthcare System
by Robert A. Olson, Vincent LaPointe, Alex Benny, Matthew Chan, Shilo Lefresne and Michael McKenzie
Curr. Oncol. 2022, 29(3), 2073-2080; https://doi.org/10.3390/curroncol29030167 - 18 Mar 2022
Cited by 1 | Viewed by 2276
Abstract
We assessed whether advanced RT techniques were associated with differences in patient-reported outcomes (PROs). Patients with bone metastases who completed the brief pain inventory (BPI) before and after RT were identified, and RT technique was categorized as simple (e.g., parallel opposed pair) or [...] Read more.
We assessed whether advanced RT techniques were associated with differences in patient-reported outcomes (PROs). Patients with bone metastases who completed the brief pain inventory (BPI) before and after RT were identified, and RT technique was categorized as simple (e.g., parallel opposed pair) or advanced (e.g., 3D-conformal RT (3DCRT), intensity-modulated RT (IMRT), or stereotactic ablative RT (SABR)). Pain response and patient-reported interference on quality of life secondary to pain was compared. A total of 1712 patients completed the BPI. From 2017–2021, the rate of advanced RT technique increased significantly (p < 0.001; 2.4%, 2.4%, 9.7%, 5.5%, 9.3%), with most advanced techniques consisting of IMRT, and only 7% of advanced techniques were SABR. Comparing simple vs. advanced technique, neither the complete pain response (12.3% vs. 11.4%; p = 0.99) nor the partial pain response (50.0% vs. 51.8%; p = 0.42) was significantly different. There was no significant patient-reported difference in pain interfering with general activity, mood, walking ability, normal work, relationships, sleep, or enjoyment of life. Given that there is increasing utilization of advanced RT techniques, there is further need for randomized trials to assess their benefits given the increased cost and inconvenience to patients. Full article
(This article belongs to the Special Issue Patient-Reported Outcome Use in Radiation Oncology Research and Routine Clinical Care)
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Review

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10 pages, 773 KiB  
Review
Striving to Fill in Gaps between Clinical Practice and Standards: The Evolution of a Pan-Canadian Approach to Patient-Reported Outcomes Use
by Amanda Caissie, Robert Olson, Lisa Barbera, Jennifer O’Donnell, Carol-Anne Davis, Jennifer Croke, Louise Bird, John Kildea, Erika Brown, Michael Brundage and Michael Milosevic
Curr. Oncol. 2022, 29(5), 3698-3707; https://doi.org/10.3390/curroncol29050296 - 19 May 2022
Cited by 4 | Viewed by 2921
Abstract
Despite the known importance and necessity of the standardized collection and use of patient-reported outcomes (PROs), there remain challenges to successful clinical implementation. Facilitated through a quality improvement initiative spearheaded by the Canadian Partnership for Quality Radiotherapy (CPQR), and now guided by the [...] Read more.
Despite the known importance and necessity of the standardized collection and use of patient-reported outcomes (PROs), there remain challenges to successful clinical implementation. Facilitated through a quality improvement initiative spearheaded by the Canadian Partnership for Quality Radiotherapy (CPQR), and now guided by the Canadian Association of Radiation Oncology (CARO)’s Quality and Standards Committee, patient representatives and early-adopter radiation treatment programs continue to champion the expansion of PROs initiatives across the country. The current review discusses the evolution of a pan-Canadian approach to PROs use, striving to fill in gaps between clinical practice and guideline recommendations through multi-centre and multidisciplinary collaboration. Full article
(This article belongs to the Special Issue Patient-Reported Outcome Use in Radiation Oncology Research and Routine Clinical Care)
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