Philipps L, Porta N, James N, Huddart R, Hafeez S, Hall E
Clinical Trials and Statistics Unit, Institute of Cancer Research, London, UK; The Institute of Cancer Research, London, UK.
The Institute of Cancer Research, London, UK.
Clin Oncol (R Coll Radiol). 2023 May;35(5):331-338. doi: 10.1016/j.clon.2023.02.003. Epub 2023 Feb 9.
To evaluate whether there is sufficient correlation between patient-reported outcomes (PROs) and clinician-reported outcomes (CROs) in bladder cancer follow-up post-radiotherapy to streamline data collection and to reduce trial follow-up burden on patients, clinicians and trial programmes.
PROs data were collected within the BC2001 trial using the Functional Assessment of Cancer Therapy specific to bladder cancer (FACT-BL) questionnaire. CROs data were collected by clinicians using Late Effects in Normal Tissues Subjective, Objective and Management (LENT/SOM). Data were collected at baseline, post-treatment, at 6 and 12 months post-randomisation and then annually to 5 years. The percentage agreement between CROs and PROs measures was evaluated at 2 and 5 years post-randomisation. Concordance was tested using the weighted Kappa statistic with 95% confidence intervals.
Correlation was evaluated between six categories of the FACT-BL and LENT/SOM scores. At 2 years the percentage agreement across these domains ranged from 45 to 78%, with the weighted Kappa statistic between 0.07 and 0.35. Results were similar in year 5 with 48-83% agreement and kappa statistics between -0.02 and 0.21.
The correlation between CROs and PROs in patients treated with radiotherapy for bladder cancer were generally poor. PROs appear to be more sensitive, with higher grade events reported. Further work is needed to evaluate whether PROs alone can be used to evaluate toxicity-related outcomes in randomised controlled trials.
评估在膀胱癌放疗后的随访中,患者报告结局(PROs)与临床医生报告结局(CROs)之间是否存在足够的相关性,以简化数据收集并减轻患者、临床医生和试验项目的试验随访负担。
在BC2001试验中,使用特定于膀胱癌的癌症治疗功能评估(FACT-BL)问卷收集PROs数据。临床医生使用正常组织晚期效应主观、客观和管理(LENT/SOM)收集CROs数据。在基线、治疗后、随机分组后6个月和12个月收集数据,然后每年收集一次,直至5年。在随机分组后2年和5年评估CROs与PROs测量之间的一致性百分比。使用加权Kappa统计量和95%置信区间检验一致性。
评估了FACT-BL的六个类别与LENT/SOM评分之间的相关性。在2年时,这些领域的一致性百分比范围为45%至78%,加权Kappa统计量在0.07至0.35之间。在第5年结果相似,一致性为48%-83%,kappa统计量在-0.02至0.21之间。
膀胱癌放疗患者中CROs与PROs之间的相关性普遍较差。PROs似乎更敏感,报告的高级别事件更多。需要进一步开展工作,以评估在随机对照试验中单独使用PROs是否可用于评估毒性相关结局。