Systematic review of outcome measures following chemo-radiotherapy for the treatment of anal cancer (CORMAC).

Systematic review of outcome measures following chemo-radiotherapy for the treatment of anal cancer (CORMAC).

Colorectal Dis. 2018 Mar 22;:

Authors: Fish R, Sanders C, Ryan N, Van der Veer S, Renehan AG, Williamson PR

Abstract
AIM: Six phase III randomised trials have determined the effectiveness of chemoradiotherapy as primary treatment for anal squamous cell carcinoma (ASCC), but outcomes reported in these trials varied widely, hindering evidence synthesis. To improve reporting in all future trials, we aim to develop a core set of outcomes (COS). As the first stage of COS development, we undertook a systematic review to summarise the outcomes reported in studies evaluating chemoradiotherapy for ASCC.
METHOD: Systematic literature searches identified studies evaluating radiotherapy or chemoradiotherapy for ASCC. Outcomes and accompanying definitions were extracted verbatim and categorised into domains.
RESULTS: From 5170 abstracts, we identified 95 eligible studies, reporting 1192 outcomes and 533 unique terms. We collapsed these terms into 86 standardised outcomes and five domains: survival; disease activity; life impact (including quality-of-life, QoL); delivery of care; and toxicity. The most commonly reported domains were survival and disease activity, reported in 74 (86%) and 54 (62%) studies, respectively. No outcome was reported in every publication. Over half (43/86) of the standardised outcome terms were reported in less than 5 studies, and 21 (25%) were reported in a single study only. There was wide variation in definitions of disease-free, colostomy-free, and progression-free survival (PFS). Anal continence was reported in only 35 (41%) studies.
CONCLUSION: Outcomes reported in studies evaluating chemoradiotherapy for ASCC were heterogenous and definitions varied widely. Outcomes likely to be important to patients such as ano-rectal function, toxicity and QoL have been neglected. A COS for future trials will address these issues. This article is protected by copyright. All rights reserved.

PMID: 29566456 [PubMed - as supplied by publisher]

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