Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UK
Objectives To identify consensus on patient prioritisation for rectal hydrogel spacer use during radiation therapy for the treatment of prostate cancer in the UK.Design Delphi study consisting of two rounds of online questionnaires, two virtual advisory board meetings and a final online questionnair...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e060506.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832575922968985600 |
|---|---|
| author | Amit Bahl Suneil Jain Albert Edwards Rhodri Saunders Clive Peedell Heather Ann Payne James Andrew Thomas Prantik Das Amanda Hansson Hedblom Emily Woodward |
| author_facet | Amit Bahl Suneil Jain Albert Edwards Rhodri Saunders Clive Peedell Heather Ann Payne James Andrew Thomas Prantik Das Amanda Hansson Hedblom Emily Woodward |
| author_sort | Amit Bahl |
| collection | DOAJ |
| description | Objectives To identify consensus on patient prioritisation for rectal hydrogel spacer use during radiation therapy for the treatment of prostate cancer in the UK.Design Delphi study consisting of two rounds of online questionnaires, two virtual advisory board meetings and a final online questionnaire.Setting Radical radiation therapy for localised and locally advanced prostate cancer in the UK.Participants Six leading clinical oncologists and one urologist from across the UK.Interventions Rectal hydrogel spacer.Primary and secondary outcome measures None reported.Results The panel reached consensus on the importance of minimising toxicity for treatments with curative intent and that even low-grade toxicity-related adverse events can significantly impact quality of life. There was agreement that despite meeting rectal dose constraints, too many patients experience rectal toxicity and that rectal hydrogel spacers in eligible patients significantly reduces toxicity-related adverse events. However, as a consequence of funding limitations, patients need to be prioritised for spacer use. A higher benefit of spacers can be expected in patients on anticoagulation and in patients with diabetes or inflammatory bowel disease, but consensus could not be reached regarding patient groups expected to benefit less. While radiation therapy regimen is not a main factor determining prioritisation, higher benefit is expected in ultrahypofractionated regimens.Conclusion There is a strong and general agreement that all patients with prostate cancer undergoing radical radiation therapy have the potential to benefit from hydrogel spacers. Currently, not all patients who could potentially benefit can access hydrogel spacers, and access is unequal. Implementation of the consensus recommendations would likely help prioritise and equalise access to rectal spacers for patients in the UK. |
| format | Article |
| id | doaj-art-873f86079a5142459d87f384d0b33b87 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-873f86079a5142459d87f384d0b33b872025-01-31T16:30:12ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060506Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UKAmit Bahl0Suneil Jain1Albert Edwards2Rhodri Saunders3Clive Peedell4Heather Ann Payne5James Andrew Thomas6Prantik Das7Amanda Hansson Hedblom8Emily Woodward92 University Hospitals Bristol NHS Foundation Trust, Bristol, UKQueen’s University Belfast, Belfast, UKKent Oncology Centre, Kent, UKCoreva Scientific GmbH und Co KG, Königswinter, GermanyDepartment of Radiotherapy and Oncology, James Cook University Hospital, Middlesbrough, UKDepartment of Oncology, University College London Hospitals NHS Foundation Trust, London, UKDepartment of Urology, Princess of Wales Hospital, Bridgend, UKDepartment of Oncology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UKCoreva Scientific GmbH und Co KG, Königswinter, GermanyHealth Economics, Boston Scientific AG, Solothurn, SwitzerlandObjectives To identify consensus on patient prioritisation for rectal hydrogel spacer use during radiation therapy for the treatment of prostate cancer in the UK.Design Delphi study consisting of two rounds of online questionnaires, two virtual advisory board meetings and a final online questionnaire.Setting Radical radiation therapy for localised and locally advanced prostate cancer in the UK.Participants Six leading clinical oncologists and one urologist from across the UK.Interventions Rectal hydrogel spacer.Primary and secondary outcome measures None reported.Results The panel reached consensus on the importance of minimising toxicity for treatments with curative intent and that even low-grade toxicity-related adverse events can significantly impact quality of life. There was agreement that despite meeting rectal dose constraints, too many patients experience rectal toxicity and that rectal hydrogel spacers in eligible patients significantly reduces toxicity-related adverse events. However, as a consequence of funding limitations, patients need to be prioritised for spacer use. A higher benefit of spacers can be expected in patients on anticoagulation and in patients with diabetes or inflammatory bowel disease, but consensus could not be reached regarding patient groups expected to benefit less. While radiation therapy regimen is not a main factor determining prioritisation, higher benefit is expected in ultrahypofractionated regimens.Conclusion There is a strong and general agreement that all patients with prostate cancer undergoing radical radiation therapy have the potential to benefit from hydrogel spacers. Currently, not all patients who could potentially benefit can access hydrogel spacers, and access is unequal. Implementation of the consensus recommendations would likely help prioritise and equalise access to rectal spacers for patients in the UK.https://bmjopen.bmj.com/content/12/7/e060506.full |
| spellingShingle | Amit Bahl Suneil Jain Albert Edwards Rhodri Saunders Clive Peedell Heather Ann Payne James Andrew Thomas Prantik Das Amanda Hansson Hedblom Emily Woodward Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UK BMJ Open |
| title | Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UK |
| title_full | Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UK |
| title_fullStr | Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UK |
| title_full_unstemmed | Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UK |
| title_short | Delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the UK |
| title_sort | delphi study to identify consensus on patient selection for hydrogel rectal spacer use during radiation therapy for prostate cancer in the uk |
| url | https://bmjopen.bmj.com/content/12/7/e060506.full |
| work_keys_str_mv | AT amitbahl delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT suneiljain delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT albertedwards delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT rhodrisaunders delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT clivepeedell delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT heatherannpayne delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT jamesandrewthomas delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT prantikdas delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT amandahanssonhedblom delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk AT emilywoodward delphistudytoidentifyconsensusonpatientselectionforhydrogelrectalspaceruseduringradiationtherapyforprostatecancerintheuk |