St-Laurent Marie-Pier, Bochner Bernard, Catto James, Davies Benjamin J, Fankhauser Christian Daniel, Garg Tullika, Hamilton-Reeves Jill, Master Viraj, Jensen Bente T, Lauridsen Susanne V, Wulff-Burchfield Elizabeth, Psutka Sarah P
Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Eur Urol. 2025 Jul;88(1):11-20. doi: 10.1016/j.eururo.2024.11.026. Epub 2024 Dec 19.
Treatment burden refers to the overall impact of medical treatments on a patient's well-being and daily life. Our objective is to evaluate the impact of treatment burden on quality of life (QoL) in patients with genitourinary (GU) malignancies, highlighting the importance of patient-reported outcomes (PROs) in clinical trials to inform treatment decisions and improve patient care.
We conducted a narrative review of clinical trials focused on GU malignancy (prostate, bladder, and kidney) between January 2000 and June 2024, analyzing related PROs and findings regarding treatment burden.
Recent landmark clinical trials demonstrate significant improvements in overall survival across GU malignancies with novel therapies. However, the reporting of QoL outcomes in these trials is often inadequate, with many lacking comprehensive data or long-term impact. Current publications are increasingly evaluating treatment burden and its impact on patient well-being as a critical outcome, but most clinical trials to date have failed to assess treatment burden across key domains including financial, time and travel, and medication management.
While advancements in treatment have extended longevity in patients with GU malignancies, the treatment burden associated with the receipt of novel agents and its implications for QoL remain inadequately uncharacterized.
治疗负担指的是医学治疗对患者幸福感和日常生活的总体影响。我们的目的是评估治疗负担对泌尿生殖系统（GU）恶性肿瘤患者生活质量（QoL）的影响，强调患者报告结局（PROs）在临床试验中对指导治疗决策和改善患者护理的重要性。
我们对2000年1月至2024年6月期间聚焦于GU恶性肿瘤（前列腺癌、膀胱癌和肾癌）的临床试验进行了叙述性综述，分析了有关治疗负担的相关PROs和研究结果。
近期具有里程碑意义的临床试验表明，新型疗法使GU恶性肿瘤患者的总生存期有了显著改善。然而，这些试验中生活质量结局的报告往往不充分，许多试验缺乏全面的数据或长期影响。当前的出版物越来越多地将治疗负担及其对患者幸福感的影响作为关键结局进行评估，但迄今为止，大多数临床试验未能在包括财务、时间和行程以及药物管理等关键领域评估治疗负担。
虽然治疗进展延长了GU恶性肿瘤患者的寿命，但与接受新型药物相关的治疗负担及其对生活质量的影响仍未得到充分描述。
