Cancer Treatment Reviews
Volume 36, Issue 6 , Pages 501-506, October 2010

Patient-reported outcomes after cytotoxic chemotherapy in metastatic castration-resistant prostate cancer: A systematic review

  • Giuseppe Colloca

      Affiliations

    • Division of Medical Oncology, ASL-1 Imperiese, Ospedale Giovanni Borea, Via Giovanni Borea, 56 I-18038 Sanremo, Imperia, Italy
    • Corresponding Author InformationCorresponding author. Address: Division of Medical Oncology, Ospedale Giovanni Borea, Via G. Borea, 56, I-18038, Sanremo (Imperia), Italy. Tel.: +39 0183 960352; fax: +39 0183 961283.
    • ,
  • Antonella Venturino

      Affiliations

    • Division of Medical Oncology, ASL-1 Imperiese, Ospedale Giovanni Borea, Via Giovanni Borea, 56 I-18038 Sanremo, Imperia, Italy
    • ,
  • Franco Checcaglini

      Affiliations

    • Division of Radiotherapy, ASL-1 Umbria, Ospedale Civile Città di Castello, Via Engels I-06012, Città di Castello Perugia, Italy

Received 13 December 2009; received in revised form 27 January 2010; accepted 1 February 2010. published online 24 February 2010.

Summary 

Background

In the clinical setting of metastatic castration-resistant prostate cancer the aim of treatment is palliation. Palliation can refer to symptom management or non-curative treatments. Patient-reported outcome is any outcome based on data provided by patients. The aim of this paper is to perform a systematic review of clinical trials including a patient-reported outcome assessment in patients treated with cytotoxic chemotherapy, and to compare their results by traditional medical and patient-reported outcomes assessment.

Methods

In November 2009 a literature search for published studies was undertaken. Selected phase-3 studies were primarily evaluated on the quality of patient-reported outcomes reporting and assessment methodology.

Findings

Health-related quality of life assessment was the most common endpoint, pain control the second one. Results of patient-reported and traditional endpoints analysis are resumed, as well as methodology assessment and quality of patient-reported outcomes reporting. Frequently, methodologic limitations affect patient-reported outcomes assessment in clinical trials, either data analysis, particularly not reporting individual scores of health-related quality of life questionnaires, statistical corrections, limited efforts to avoid missing data, or lacking report of duration of palliative response.

Conclusions

Results of trials can differ if different outcomes, medical or patient-reported, are considered in the analysis. Cytotoxic chemotherapy of metastatic castration-resistant prostate cancer is a challenging issue. A survival benefit is reported only for docetaxel, but this treatment is not always feasible. In all patients, initiation of chemotherapy should be based on patient’s preferences within discussion of individual risk and benefit, particularly in patients with extensive asymptomatic and symptomatic metastases.

Keywords: Chemotherapy, Health-related quality of life, Pain, Patient-related outcomes, Prostate cancer

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PII: S0305-7372(10)00021-6

doi:10.1016/j.ctrv.2010.02.001

Cancer Treatment Reviews
Volume 36, Issue 6 , Pages 501-506, October 2010

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