Increasing Life Expectancy in Patients with Genitourinary Malignancies: Impact of Treatment Burden on Disease Management and Quality of Life

IF 25.3 1区医学 Q1 UROLOGY & NEPHROLOGY European urology Pub Date : 2024-12-19 DOI:10.1016/j.eururo.2024.11.026

Marie-Pier St-Laurent, Bernard Bochner, James Catto, Benjamin J. Davies, Christian Daniel Fankhauser, Tullika Garg, Jill Hamilton-Reeves, Viraj Master, Bente T. Jensen, Susanne V. Lauridsen, Elizabeth Wulff-Burchfield, Sarah P. Psutka

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Abstract

Background and objective

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.

Methods

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.

Key findings and limitations

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.

Conclusions and clinical implications

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.

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泌尿生殖系统恶性肿瘤患者预期寿命增加：治疗负担对疾病管理和生活质量的影响

背景与目的治疗负担是指医疗对患者健康和日常生活的整体影响。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，强调临床试验中患者报告结果（PROs）的重要性，以告知治疗决策和改善患者护理。方法对2000年1月至2024年6月期间针对GU恶性肿瘤（前列腺、膀胱和肾脏）的临床试验进行叙述性回顾，分析相关优点和治疗负担方面的发现。主要发现和局限性最近具有里程碑意义的临床试验表明，采用新疗法可显著改善GU恶性肿瘤的总生存率。然而，这些试验中生活质量结果的报告往往不充分，许多试验缺乏全面的数据或长期影响。目前的出版物越来越多地将治疗负担及其对患者福祉的影响作为一个关键结果进行评估，但迄今为止，大多数临床试验未能评估包括财务、时间和旅行以及药物管理在内的关键领域的治疗负担。结论和临床意义虽然治疗的进步延长了GU恶性肿瘤患者的寿命，但与接受新药物相关的治疗负担及其对生活质量的影响仍不充分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European urology 医学-泌尿学与肾脏学

CiteScore

43.00

自引率

2.60%

发文量

1753

审稿时长

23 days

期刊介绍： European Urology is a peer-reviewed journal that publishes original articles and reviews on a broad spectrum of urological issues. Covering topics such as oncology, impotence, infertility, pediatrics, lithiasis and endourology, the journal also highlights recent advances in techniques, instrumentation, surgery, and pediatric urology. This comprehensive approach provides readers with an in-depth guide to international developments in urology.