Patient-Reported Outcomes Associated with Treatments for Testicular Cancer: A Systematic Review

Rebecca Mercieca-Bebber; Sayeda Kamrun Naher; Orlando Rincones; Allan Ben Smith; Martin R Stockler

doi:10.2147/PROM.S242754

Patient-Reported Outcomes Associated with Treatments for Testicular Cancer: A Systematic Review

Patient Relat Outcome Meas. 2021 Jun 8:12:129-171. doi: 10.2147/PROM.S242754. eCollection 2021.

Authors

Rebecca Mercieca-Bebber¹, Sayeda Kamrun Naher¹, Orlando Rincones², Allan Ben Smith², Martin R Stockler¹

Affiliations

¹ NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia.
² Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research & University of New South Wales, Liverpool, New South Wales, Australia.

Abstract

Background: Testicular cancer and its treatment can have major short- and long-term effects on the health-related quality of life of those affected. This systematic review aims to summarise patient-reported outcome (PRO) data concerning health-related quality of life, functional impacts and common side-effects of treatments for testicular cancer.

Methods: We systematically searched Medline OVID, CINAHL, PubMed, Embase and the Patient-Reported Outcomes Over Time In Oncology (PROMOTION) databases from inception to 25 March 2020, using "testicular cancer" and "PRO" search terms developed in conjunction with a medical librarian. Two authors screened abstracts and full-text articles for studies that reported primary PRO data related to the treatment of testicular cancer including at least 50 participants. We excluded psychosocial data as this was included in our companion review. Data were extracted by three reviewers, and quality was assessed by two reviewers using QUAL-SYST. Studies with a quality of score over 65% were included in our narrative synthesis.

Results: A total of 1831 records were identified via our database searches and 41 met inclusion criteria. Of these, 35 included participants who had chemotherapy. Twenty-eight different PRO measures were used across the 41 studies. Of the 41 studies, 29 had quality scores over 65% and were included in our narrative synthesis. We found that chemotherapy was generally associated with a higher side-effect burden than other treatments, and higher burden was associated with higher doses of chemotherapy. Hearing problems, peripheral neuropathy, and Raynaud's phenomena were particularly common side-effects. Problems with sexual functioning were associated with chemotherapy, radiotherapy and surgery.

Discussion: While many studies found that between-treatment differences resolved within the first 12 months since diagnosis, there were many long-term and dose-dependent impacts associated with chemotherapy and radiotherapy across PRO domains. Offering information about these aspects, and information about expected survival outcomes, will help inform, prepare, and empower patients to make decisions about treatment aligned with their preferences and personal situations.

Keywords: cancer survivorship; patient-reported outcomes; quality of life; testicular cancer.

Publication types

Review