Alexander S E, Oelfke U, McNair H A, Tree A C
The Royal Marsden NHS Foundation Trust, United Kingdom and The Institute of Cancer Research, United Kingdom.
The Joint Department of Physics, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, United Kingdom.
Clin Transl Radiat Oncol. 2023 Feb 26;40:100604. doi: 10.1016/j.ctro.2023.100604. eCollection 2023 May.
A scoping literature review was conducted to identify gastrointestinal (GI) factors most likely to influence prostate motion during radiotherapy. We proffer that patient specific measurement of these GI factors could predict motion uncertainty during radiotherapy, facilitating personalised care by optimising treatment technique e.g., daily adaption or via bespoke patient pre-habilitation and preparation.
The scoping review was undertaken as per JBI guidelines. Searches were conducted across four databases: Ovid Medline®, EMBASE, CINAHL and EBSCO discovery. Articles written in English from 2010-present were included. Those pertaining to paediatrics, biological women exclusively, infectious and post-treatment GI morbidity and diet were excluded.Common GI factors impacting men were identified and related symptoms, incidence and measurement tools examined. Prevalence among persons with prostate cancer was explored and suitable assessment tools discussed.
A preliminary search identified four prominent GI-factors: mental health, co-morbidity and medication, physical activity, and pelvic floor disorder. The scoping search found 3644 articles; 1646 were removed as duplicates. A further 1249 were excluded after title and abstract screening, 162 remained subsequent to full text review: 42 mental health, 53 co-morbidity and medication, 39 physical activity and 28 pelvic floor disorder.Six GI factors prevalent in the prostate cancer population and estimated most likely to influence prostate motion were identified: depression, anxiety, diabetes, obesity, low physical activity, and pelvic floor disorder. Reliable, quick, and easy to use tools are available to quantify these factors.
A comprehensive GI factor assessment package suitable to implement into the radiotherapy clinic has been created. Unveiling these GI factors upfront will guide improved personalisation of radiotherapy.
开展一项范围界定文献综述，以确定在放射治疗期间最有可能影响前列腺运动的胃肠道（GI）因素。我们提出，针对这些GI因素进行患者特异性测量可以预测放射治疗期间的运动不确定性，通过优化治疗技术（例如每日调整或通过定制的患者预适应和准备）来促进个性化护理。
按照JBI指南进行范围界定综述。在四个数据库中进行检索：Ovid Medline®、EMBASE、CINAHL和EBSCO发现数据库。纳入2010年至今以英文撰写的文章。排除与儿科、仅涉及生物学女性、感染性和治疗后GI发病率及饮食相关的文章。确定了影响男性的常见GI因素，并对相关症状、发病率和测量工具进行了研究。探讨了前列腺癌患者中的患病率，并讨论了合适的评估工具。
初步检索确定了四个突出的GI因素：心理健康、合并症和药物治疗、身体活动以及盆底功能障碍。范围界定检索共找到3644篇文章；1646篇因重复而被剔除。在标题和摘要筛选后又排除了1249篇，全文审查后剩下162篇：42篇关于心理健康，53篇关于合并症和药物治疗，39篇关于身体活动，28篇关于盆底功能障碍。确定了前列腺癌人群中普遍存在且最有可能影响前列腺运动的六个GI因素：抑郁、焦虑、糖尿病、肥胖、身体活动不足和盆底功能障碍。有可靠、快速且易于使用的工具可用于量化这些因素。
已创建了一个适合在放射治疗诊所实施的全面GI因素评估包。预先揭示这些GI因素将指导改进放射治疗的个性化。
