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Sharp, L., Fransson, P., Fowler, M. & Ullgren, H. (2024). Aspects of occupational safety: a survey among European cancer nurses. European Journal of Oncology Nursing, 70, Article ID 102595.
Open this publication in new window or tab >>Aspects of occupational safety: a survey among European cancer nurses
2024 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 70, article id 102595Article in journal (Refereed) Published
Abstract [en]

Purpose: Nurses are particularly at risk for occupational exposure to hazardous cancer drugs, risking both acute and chronic health effects. Knowledge on the implemented safety precautions into minimizing these risks is limited.

Methods: The European Cancer Nursing Index (ECNI) was developed by the European Oncology Nursing Society (EONS) to illustrate the development and status of this profession. In this study, anonymous online survey data on occupational safety reported by European cancer nurses as part of the ECNI 2022, was analysed.

Results: A total of 630 cancer nurses from 29 countries responded to the survey. A majority reported that written guidelines (n = 553, 88%) on safe handling and administration of hazardous drugs, personal protection equipment (PPE) and cytotoxic spillage kits (n = 514, 82%) were available at their workplaces. 130 (21%) nurses reported that wipe testing to assess any residual hazardous drugs on workplace surfaces were conducted systematically at their workplaces. 185 (29%) nurses reported that nurses sometimes or always continued with their regular tasks (including handling hazardous cancer drugs) during pregnancy and breast feeding. 185 (29%) also responded that nurses at their workplaces did not receive an introductory education program before handling hazardous drugs. In total, 346 (55%) of the nurses reported that their workplace had a freedom to speak-up guardian or whistle blower policy for members of staff.

Conclusions: Even if most nurses report that there are safety routines in place at their workplaces, the results reveal several serious occupational risks for European nurses handling hazardous cancer drugs. Actions are needed to improve and optimize occupational safety for nursing staff.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Cancer, Hazardous drugs, Nursing, Occupational safety, Safety culture, Working conditions
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-223955 (URN)10.1016/j.ejon.2024.102595 (DOI)2-s2.0-85191164347 (Scopus ID)
Available from: 2024-05-03 Created: 2024-05-03 Last updated: 2024-05-03Bibliographically approved
Corsini, C., Bergengren, O., Carlsson, S., Garmo, H., Hjelm-Eriksson, M., Fransson, P., . . . Carlsson, S. V. (2024). Patient-reported side effects 1 year after radical prostatectomy or radiotherapy for prostate cancer: a register-based nationwide study. European Urology Oncology, 7(3), 605-613
Open this publication in new window or tab >>Patient-reported side effects 1 year after radical prostatectomy or radiotherapy for prostate cancer: a register-based nationwide study
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2024 (English)In: European Urology Oncology, E-ISSN 2588-9311, Vol. 7, no 3, p. 605-613Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Data on functional and psychological side effects following curative treatment for prostate cancer are lacking from large, contemporary, unselected, population-based cohorts.

OBJECTIVE: To assess urinary symptoms, bowel disturbances, erectile dysfunction (ED), and quality of life (QoL) 12 mo after robot-assisted radical prostatectomy (RARP) and radiotherapy (RT) using patient-reported outcome measures in the Swedish prostate cancer database.

DESIGN, SETTING, AND PARTICIPANTS: This was a nationwide, population-based, cohort study in Sweden of men who underwent primary RARP or RT between January 1, 2018 and December 31, 2020.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Absolute proportions and odds ratios (ORs) were calculated using multivariable logistic regression, with adjustment for clinical characteristics.

RESULTS AND LIMITATIONS: A total of 2557 men underwent RARP and 1741 received RT. Men who underwent RT were older (69 vs 65 yr) and had more comorbidities at baseline. After RARP, 13% of men experienced incontinence, compared to 6% after RT. The frequency of urinary bother was similar, at 18% after RARP and 18% after RT. Urgency to defecate was reported by 14% of men after RARP and 34% after RT. At 1 yr, 73% of men had ED after RARP, and 77% after RT. High QoL was reported by 85% of men after RARP and 78% of men after RT. On multivariable regression analysis, RT was associated with lower risks of urinary incontinence (OR 0.25, 95% confidence interval [CI] 0.19-0.33), urinary bother (OR 0.79, 95% CI 0.66-0.95), and ED (OR 0.54, 95% CI 0.46-0.65), but higher risk of bowel symptoms (OR 2.86, 95% CI 2.42-3.39). QoL was higher after RARP than after RT (OR 1.34, 95% CI 1.12-1.61).

CONCLUSIONS: Short-term specific side effects after curative treatment for prostate cancer significantly differed between RARP and RT in this large and unselected cohort. Nevertheless, the risk of urinary bother was lower after RT, while higher QoL was common after RARP.

PATIENT SUMMARY: In our study of patients treated for prostate cancer, urinary bother and overall quality of life are comparable at 1 year after surgical removal of the prostate in comparison to radiotherapy, despite substantial differences in other side effects.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Patient-reported outcomes, Population-based study, Prostate cancer, Radical prostatectomy, Radiotherapy
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-223032 (URN)10.1016/j.euo.2023.12.007 (DOI)38233329 (PubMedID)2-s2.0-85193645009 (Scopus ID)
Funder
Swedish Cancer Society, 222051PjStiftelsen Hillevi Fries forskningsfondStiftelsen Johanna Hagstrand och Sigfrid Linnérs MinneSwedish Society of Medicine
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-05-27Bibliographically approved
Rönningås, U., Holm, M., Fransson, P., Beckman, L. & Wennman-Larsen, A. (2024). Symptoms and quality of life among men starting treatment for metastatic castration-resistant prostate cancer: a prospective multicenter study. BMC Palliative Care, 23(1), Article ID 80.
Open this publication in new window or tab >>Symptoms and quality of life among men starting treatment for metastatic castration-resistant prostate cancer: a prospective multicenter study
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2024 (English)In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 23, no 1, article id 80Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Men with metastatic castration-resistant prostate cancer (mCRPC) have an incurable disease. Along with prolonging life, symptom management is one of the main goals with treatment. This is also important from a palliative care perspective where the life prolonging outcomes should be balanced with quality of life (QoL) in this late phase. It is also essential in symptom management to view different dimensions of symptoms, for example how severe or distressing symptoms are, to support best QoL. Therefore, more knowledge is needed about the symptom experience when these treatments are initiated and thus the aim of this study was to describe different dimensions of symptoms in men with mCRPC starting their first-line of life-prolonging treatment, and to describe the association between symptom burden and QoL.

METHODS: Baseline data from a prospective longitudinal study of 143 men with mCRPC starting their first-line life-prolonging treatment were used. Symptoms were measured using the Memorial Symptom Assessment Scale (MSAS) and global QoL was measured by the EORTC QLQ C-30. Data was analyzed using descriptive- and multivariable linear regression analyses.

RESULTS: On average, the men had more than 10 symptoms (range 0-31 of 33). 50% or more reported sweats, lack of energy, pain, problems with sexual activity and sexual desire. The symptoms they reported as most severe, or most distressing were not always the ones that were reported as most frequent. There was an association between QoL and physical symptoms, and also between QoL, and analgesic use and prostate-specific antigen (PSA) values.

CONCLUSION: Even if some men with mCRPC report many symptoms, the dimensions of severity and distress levels vary, and the most frequent symptoms was not always the most burdensome or distressing. There was an association between high physical symptom burden and QoL, suggesting that it is not the number of symptoms that affects QoL but rather the subjective perceived impact of the physical symptoms experienced. The knowledge of how men with mCRPC experience and perceive their symptoms may help health care professionals in symptom management aiming to improve QoL, which is a cornerstone in integrating early palliative care.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Early integrated palliative care, MSAS, Metastatic castration-resistant prostate cancer, Prostatic neoplasm, Quality of life, Symptom burden, Symptom management
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-223031 (URN)10.1186/s12904-024-01410-w (DOI)001191215600001 ()38532425 (PubMedID)2-s2.0-85188672318 (Scopus ID)
Funder
ProstatacancerförbundetSjöberg Foundation, 2020-01-07-05The Kamprad Family Foundation, 2170260
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-04-09Bibliographically approved
Johansson, B., Cajander, Å., Ahmad, A., Ohlsson-Nevo, E., Fransson, P., Granström, B., . . . Ehrsson, Y. T. (2024). The effect of internet-administered support (carer eSupport) on preparedness for caregiving in informal caregivers of patients with head and neck cancer compared with support as usual: a study protocol for a randomized controlled trial. BMC Cancer, 24(1), Article ID 494.
Open this publication in new window or tab >>The effect of internet-administered support (carer eSupport) on preparedness for caregiving in informal caregivers of patients with head and neck cancer compared with support as usual: a study protocol for a randomized controlled trial
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2024 (English)In: BMC Cancer, E-ISSN 1471-2407, Vol. 24, no 1, article id 494Article in journal (Refereed) Published
Abstract [en]

Background: Informal caregivers (ICs) of patients with cancer provide essential and mainly uncompensated care. A self-perceived preparedness to care for the patient is associated with a lower caregiver burden, described as the extent to which caregiving is perceived as having adverse effects on IC functioning and well-being. ICs’ well-being is associated with patient-perceived quality of care, suggesting that interventions to optimize ICs’ health are essential in order to improve patient care. Head and neck cancer (HNC) is the seventh most common malignant disease in the world. The disease and its treatment have a significant negative impact on the patient’s health and quality of life. Symptoms usually interfere with swallowing, food and fluid intake, breathing, speaking, and communication. ICs frequently manage patients’ symptoms and side effects, especially problems related to nutrition and oral pain, without being properly prepared. Carer eSupport is an Internet-administered intervention, based on focus group discussions with ICs, developed in collaboration with ICs and healthcare professionals, tested for feasibility, and deemed feasible. This study protocol outlines the methods of investigating the effects of Carer eSupport plus support as usual (SAU) on self-reported preparedness for caregiving, caregiver burden, and well-being in the ICs of patients with HNC, compared with ICs receiving SAU only.

Methods and analysis: In this randomized controlled trial, 110 ICs of patients with HNC, undergoing radiotherapy combined with surgery and/or medical oncological treatment, will be randomized (1:1) to Carer eSupport plus SAU or SAU only. Data will be collected at baseline (before randomization), post-intervention (after 18 weeks), and 3 months after post-intervention. The primary outcome is self-reported preparedness for caregiving. Secondary outcomes are self-reported caregiver burden, anxiety, depression, and health-related quality of life. The effect of Carer eSupport plus SAU on preparedness for caregiving and secondary outcomes, compared with SAU only, will be evaluated by intention to treat analyses using linear regression models, mixed-model regression, or analysis of covariance.

Discussion: If proven effective, Carer eSupport has the potential to significantly improve ICs’ preparedness for caregiving and their wellbeing, thereby improving patient-perceived quality of care and patient wellbeing.

Trial registration: ClinicalTrials.gov; NCT06307418, registered 12.03.2024 (https://clinicaltrials.gov/search? term=NCT06307418).

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Caregiver burden, Head and neck cancer, Informal caregivers, Internet-administered support, Preparedness for caregiving, Quality of life
National Category
Cancer and Oncology Nursing
Identifiers
urn:nbn:se:umu:diva-224123 (URN)10.1186/s12885-024-12273-y (DOI)001205523400002 ()38637744 (PubMedID)2-s2.0-85191008033 (Scopus ID)
Funder
Swedish Research Council, 2019−01231Swedish Cancer Society, 20 1014 PjFStiftelsen Onkologiska Klinikens i Uppsala ForskningsfondRegion Uppsala, ALF-941900
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-07-04Bibliographically approved
Sjövall, K., Ahlberg, K., Fessé, P., Fransson, P., Kristensen, I., Ohlsson-Nevo, E., . . . Langegård, U. (2024). To become part of the team—patient experiences of participating in decision-making for a new treatment (proton beam therapy). Supportive Care in Cancer, 32(7), Article ID 442.
Open this publication in new window or tab >>To become part of the team—patient experiences of participating in decision-making for a new treatment (proton beam therapy)
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2024 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 32, no 7, article id 442Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to explore patients’ experience of participation in the treatment decision of proton beam therapy versus conventional radiotherapy.

Background: Proton beam therapy (PBT) has become a treatment option for some cancer patients receiving radiotherapy. The decision to give PBT instead of conventional radiotherapy (CRT) needs to be carefully planned together with the patient to ensure that the degree of participation is based on individuals’ preferences. There is a knowledge gap of successful approaches to support patients’ participation in the decision-making process, which is particularly important when it comes to the situation of having to choose between two treatment options such as PBT and CRT, with similar expected outcomes.

Method: We conducted a secondary analysis of qualitative data collected from interviews with patients who received PBT for their brain tumor. Transcribed verbatims from interviews with 22 patients were analyzed regarding experiences of participation in the decision-making process leading to PBT.

Findings: Participants experienced their participation in the decision-making process to a varying degree, and with individual preferences. Four themes emerged from data: to be a voice that matters, to get control over what will happen, being in the hand of doctors’ choice, and feeling selected for treatment.

Conclusion: A decision for treatment with PBT can be experienced as a privilege but can also cause stress as it might entail practical issues affecting everyday life in a considerable way. For the patient to have confidence in the decision-making process, patients’ preferences, expectations, and experiences must be included by the healthcare team. Including the patient in the healthcare team as an equal partner by confirming the person enables and facilitates for patients’ voice to be heard and reckoned with. Person-centered care building on a partnership between patients and healthcare professionals should provide the right basis for the decision-making process.

Place, publisher, year, edition, pages
Springer, 2024
Keywords
Participation in care, Proton beam therapy, Radiotherapy, Shared decision making
National Category
Nursing Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-227300 (URN)10.1007/s00520-024-08631-y (DOI)001250659600004 ()38890189 (PubMedID)2-s2.0-85196314840 (Scopus ID)
Available from: 2024-07-03 Created: 2024-07-03 Last updated: 2024-07-03Bibliographically approved
Al-Zaidi, Z., Lindam, A., Fransson, P. & Samuelsson, E. (2023). A mobile app as support for pelvic floor muscle training started prior to radical prostatectomy. BJUI Compass, 4(1), 114-122
Open this publication in new window or tab >>A mobile app as support for pelvic floor muscle training started prior to radical prostatectomy
2023 (English)In: BJUI Compass, E-ISSN 2688-4526, Vol. 4, no 1, p. 114-122Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the usefulness of a mobile app to support pelvic floor muscle training (PFMT) started prior to radical prostatectomy (RP).

Materials and methods: A prospective cohort study conducted in Sweden from June 2018 to February 2021 including men for whom RP was planned within 12 months. Users responded anonymously to questionnaires at baseline, 1 and 3 months. Our primary aim was to evaluate if the app could facilitate PFMT and increase confidence in performing pelvic floor muscle (PFM) contractions correctly. Our second aim was to describe the change in urinary incontinence (UI) after RP, based on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF).

Results: Of the 3043 users at baseline, 388 met the primary inclusion criteria. Of those, 71 (18.3%) were incontinent, predominantly with slight symptoms. The most common type was urge UI, 39/71 (54.9%). Of the 388 users, 159 (41.0%) answered the questionnaire at 1 month, and 131 (33.7%) at 3 months within 89–135 days. Of those 131, 127 (96.9%) indicated that the app facilitated their training ‘a lot’ or ‘somewhat’. Confidence in performing PFM contractions correctly increased from 39.7% at baseline to 74.0% at 1 month and 87.8% at 3 months (p < 0.001). At baseline, 19.8% performed PFM contractions at least daily, which increased to 74.0% at 1 month and 77.9% at 3 months (p < 0.001). At 3 months, 115/131 (87.8%) had undergone RP, 93.6% of which were robot-assisted. Of the 115, 103 (89.6%) were incontinent, and stress UI dominated. The mean ICIQ-UI SF score increased from 1.2 (2.4 SD) at baseline to 9.6 (5.2 SD), p < 0.001, after surgery.

Conclusions: The mobile app facilitated pelvic floor muscle training for men who were planned to undergo radical prostatectomy and used the app.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
mobile application, pelvic floor muscle training, radical prostatectomy, self-management, urinary incontinence
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-216797 (URN)10.1002/bco2.142 (DOI)36569504 (PubMedID)2-s2.0-85175088954 (Scopus ID)
Funder
Region Jämtland Härjedalen, JLL 940038Visare Norr, 931113The Kamprad Family Foundation, 20170202Prostatacancerförbundet, 2019022
Available from: 2023-11-16 Created: 2023-11-16 Last updated: 2024-06-24Bibliographically approved
Widgren, Y., Silén, M., Wåhlin, I., Lindberg, M., Fransson, P. & Efverman, A. (2023). Chemotherapy-induced emesis: experienced burden in life, and significance of treatment expectations and communication in chemotherapy care. Integrative Cancer Therapies, 22
Open this publication in new window or tab >>Chemotherapy-induced emesis: experienced burden in life, and significance of treatment expectations and communication in chemotherapy care
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2023 (English)In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 22Article in journal (Refereed) Published
Abstract [en]

Objective: Because antiemetics have become more effective and integrative therapies such as acupuncture are used in combination with antiemetics, people receiving chemotherapy for cancer today might expect less emesis than in the past. It is not previously described if and how people receiving modern antiemetics during chemotherapy experience emesis. The objective of this study was to describe experiences regarding emesis among persons undergoing emetogenic chemotherapy, and how it affects their quality of life, daily life and work. A further aim was to describe views on the significance of treatment expectations and communication with healthcare personnel while undergoing chemotherapy for cancer.

Method: Fifteen participants (median age 62 years, n = 1 man and n = 14 women, with breast (n = 13) or colorectal (n = 2) cancer) undergoing adjuvant or neo-adjuvant highly or moderately emetogenic chemotherapy were interviewed individually. The data were then analyzed using inductive thematic analysis.

Results: Three themes described the participants’ experiences: “Your whole life is affected, or continues as usual,” covering descriptions of emesis limiting some participants’ everyday lives, while others experienced no emesis at all or had found ways to manage it. Overall, participants described satisfaction with their antiemetic treatment. “Experiences and expectations more important than information”, that is, the participants reported wanting all the information they could get about possible adverse effects of treatment, although they believed previous experiences were more important than information in creating expectations about treatment outcomes. The participants reported that being seen as a unique person was of utmost importance: “Meet me as I am.” This creates trust in healthcare personnel and a feeling of safety and security in the situation.

Conclusions: These findings underline the importance of person-centered care and support in creating positive treatment expectations. Future research is called for regarding the potential antiemetic effects of positive communication regarding strengthening positive treatment expectations during emetogenic chemotherapy.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
cancer care, communication, expectations, nausea, person-centered care
National Category
Cancer and Oncology Nursing
Identifiers
urn:nbn:se:umu:diva-218628 (URN)10.1177/15347354231217296 (DOI)38098295 (PubMedID)2-s2.0-85179678460 (Scopus ID)
Funder
The Breast Cancer FoundationCancerforskningsfonden i NorrlandRegion VästernorrlandSigne and Olof Wallenius FoundationUniversity of Gävle
Available from: 2023-12-27 Created: 2023-12-27 Last updated: 2024-01-11Bibliographically approved
Wode, K., Sharp, L., Fransson, P. & Hök Nordberg, J. (2023). Communication about complementary and alternative medicine when patients decline  conventional cancer treatment: patients' and physicians' experiences. The Oncologist, 28(9), e774-e783
Open this publication in new window or tab >>Communication about complementary and alternative medicine when patients decline  conventional cancer treatment: patients' and physicians' experiences
2023 (English)In: The Oncologist, ISSN 1083-7159, E-ISSN 1549-490X, Vol. 28, no 9, p. e774-e783Article in journal (Refereed) Published
Abstract [en]

Background: Complementary and alternative medicine (CAM) is a broad set of nonconventional practices used alongside or instead of conventional treatment: The latter poses obvious risks related to cancer prognosis. Patient-physician dialogue about CAM is crucial for patient safety and mutual trust. Little is known about communication in the rare situations when patients decline recommended cancer treatment and consider using CAM. The objective of this study was to explore patients' and physicians' experiences from situations when patients decline recommended cancer treatment and consider using CAM.

Materials and methods: Semi-structured interviews were carried out with 7 CAM-using cancer patients who had declined some or all conventional treatment as well as 10 physicians from oncology and palliative care. Framework analysis was used.

Results: Regarding treatment choices, there was a dissonance between physicians' focus on medical reasoning and patients' expression of complex values. Physicians' difficulty in understanding patients' treatment decline was exacerbated when patients considered using CAM, impairing communication even further. Inequalities in roles resulting in power struggles risked pushing both parties toward extreme and inflexible standpoints. Despite these challenges regarding treatment choices and hierarchical roles, both parties considered open and respectful communication as crucial.

Conclusions: This study highlights the difficulty of shared decision-making in practice when patients' and physicians' views on treatment decisions deviate in clinically challenging situations. Our results point to a need to address the complexity of these situations, pay attention to patients' values, and improve knowledge among physicians about CAM.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
neoplasms, complementary therapies, treatment refusal, communication, physician-patient relations, qualitative research
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-194750 (URN)10.1093/oncolo/oyad084 (DOI)000974142300001 ()37071805 (PubMedID)2-s2.0-85170294322 (Scopus ID)
Note

Originally included in thesis in manuscript form. 

Available from: 2022-05-16 Created: 2022-05-16 Last updated: 2023-09-26Bibliographically approved
Sjövall, K., Langegård, U., Fransson, P., Nevo-Ohlsson, E., Kristensen, I., Ahlberg, K. & Johansson, B. (2023). Evaluating patient reported outcomes and experiences in a novel proton beam clinic – challenges, activities, and outcomes of the ProtonCare project. BMC Cancer, 23(1), Article ID 132.
Open this publication in new window or tab >>Evaluating patient reported outcomes and experiences in a novel proton beam clinic – challenges, activities, and outcomes of the ProtonCare project
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2023 (English)In: BMC Cancer, E-ISSN 1471-2407, Vol. 23, no 1, article id 132Article in journal (Refereed) Published
Abstract [en]

Background: The ProtonCare Study Group (PCSG) was formed with the purpose to develop and implement a framework for evaluation of proton beam therapy (PBT) and the related care at a novel clinic (Skandionkliniken), based on patient reported data.

Method: A logic model framework was used to describe the process of development and implementation of a structured plan for evaluation of PBT for all diagnoses based on patient reported data. After the mission for the project was determined, meetings with networks and stakeholders were facilitated by PCSG to identify assumptions, resources, challenges, activities, outputs, outcomes, and outcome indicators.

Result: This paper presents the challenges and accomplishments PCSG made so far. We describe required resources, activities, and accomplished results. The long-term outcomes that were outlined as a result of the process are two; 1) Improved knowledge about health outcomes of patients that are considered for PBT and 2) The findings will serve as a base for clinical decisions when patients are referred for PBT.

Conclusion: Using the logical model framework proved useful in planning and managing the ProtonCare project. As a result, the work of PCSG has so far resulted in long-lasting outcomes that creates a base for future evaluation of patients’ perspective in radiotherapy treatment in general and in PBT especially. Our experiences can be useful for other research groups facing similar challenges. Continuing research on patients´ perspective is a central part in ongoing and future research. Collaboration, cooperation, and coordination between research groups/networks from different disciplines are a significant part of the work aiming to determine the more precise role of PBT in future treatment options.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Cancer nursing, Patient reported outcomes, Proton beam therapy, Radiotherapy, Research program planning
National Category
Nursing Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-204998 (URN)10.1186/s12885-023-10586-y (DOI)000931458600003 ()36759789 (PubMedID)2-s2.0-85147787768 (Scopus ID)
Available from: 2023-03-03 Created: 2023-03-03 Last updated: 2024-07-04Bibliographically approved
Björeland, U., Notstam, K., Fransson, P., Söderkvist, K., Beckman, L., Jonsson, J., . . . Thellenberg-Karlsson, C. (2023). Hyaluronic acid spacer in prostate cancer radiotherapy: dosimetric effects, spacer stability and long-term toxicity and PRO in a phase II study. Radiation Oncology, 18(1), Article ID 1.
Open this publication in new window or tab >>Hyaluronic acid spacer in prostate cancer radiotherapy: dosimetric effects, spacer stability and long-term toxicity and PRO in a phase II study
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2023 (English)In: Radiation Oncology, E-ISSN 1748-717X, Vol. 18, no 1, article id 1Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Perirectal spacers may be beneficial to reduce rectal side effects from radiotherapy (RT). Here, we present the impact of a hyaluronic acid (HA) perirectal spacer on rectal dose as well as spacer stability, long-term gastrointestinal (GI) and genitourinary (GU) toxicity and patient-reported outcome (PRO).

METHODS: In this phase II study 81 patients with low- and intermediate-risk prostate cancer received transrectal injections with HA before external beam RT (78 Gy in 39 fractions). The HA spacer was evaluated with MRI four times; before (MR0) and after HA-injection (MR1), at the middle (MR2) and at the end (MR3) of RT. GI and GU toxicity was assessed by physician for up to five years according to the RTOG scale. PROs were collected using the Swedish National Prostate Cancer Registry and Prostate cancer symptom scale questionnaires.

RESULTS: There was a significant reduction in rectal V70% (54.6 Gy) and V90% (70.2 Gy) between MR0 and MR1, as well as between MR0 to MR2 and MR3. From MR1 to MR2/MR3, HA thickness decreased with 28%/32% and CTV-rectum space with 19%/17% in the middle level. The cumulative late grade ≥ 2 GI toxicity at 5 years was 5% and the proportion of PRO moderate or severe overall bowel problems at 5 years follow-up was 12%. Cumulative late grade ≥ 2 GU toxicity at 5 years was 12% and moderate or severe overall urinary problems at 5 years were 10%.

CONCLUSION: We show that the HA spacer reduced rectal dose and long-term toxicity.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Hyaluronic Acid, Prostate cancer, Radiotherapy, Rectal toxicity
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-203799 (URN)10.1186/s13014-022-02197-x (DOI)000906713000001 ()36593460 (PubMedID)2-s2.0-85145492354 (Scopus ID)
Funder
Region VästernorrlandCancerforskningsfonden i NorrlandVisare Norr
Available from: 2023-01-20 Created: 2023-01-20 Last updated: 2024-07-04Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1248-5581

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