Patient experience and quality of life during neoadjuvant therapy for pancreatic cancer: a systematic review and study p
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ORIGINAL ARTICLE
Patient experience and quality of life during neoadjuvant therapy for pancreatic cancer: a systematic review and study protocol Jordan M. Cloyd 1,2 & Sarah Hyman 3 & Tanya Huwig 4 & Christina Monsour 1 & Heena Santry 1 & Celia Wills 5 & Allan Tsung 1 & John F. P. Bridges 1,3,4 Received: 30 July 2020 / Accepted: 2 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Neoadjuvant therapy (NT) is increasingly being offered to patients with pancreatic ductal adenocarcinoma (PDAC) prior to surgical resection. However, the experience and quality of life (QOL) of patients undergoing NT are poorly understood. Methods A systematic review of the Cinahl, Embase, Medline, Pubmed, Scopus, and Web of Science databases was conducted to evaluate the available literature pertaining to the experience and QOL of patient’s undergoing NT for PDAC. Results Among 6041 articles screened, only six met criteria for full-text review including three prospective clinical trials of NT with QOL secondary endpoints. Overall, global QOL during or following NT did not significantly change from baseline. Pain scores seemed to improve during NT while the impact of NT on physical functioning varied across studies. No studies were identified evaluating other aspects of the patient experience. Conclusion Although NT appears to have a minor impact on the QOL of patients with PDAC, this systematic review identified significant evidence gaps in the literature. A protocol of a prospective observational cohort study utilizing a digital smartphone app that aims to evaluate the patient experience and longitudinal QOL of patients with PDAC undergoing NT is presented. Keywords Psychological impact . Patient-reported outcomes . Supportive care . Pancreatic ductal adenocarcinoma . Palliative care . Patient preferences
Introduction Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with high recurrence rates following surgical resection [1, 2]. Increasingly, patients with resectable and borderline
* Jordan M. Cloyd [email protected] 1
Department of Surgery, College of Medicine, The Ohio State Wexner Medical Center, Columbus, OH, USA
2
Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 410 W 10th Ave, N-907 Doan Hall, Columbus, OH 43210, USA
3
College of Public Health, The Ohio State Wexner Medical Center, Columbus, OH, USA
4
Department of Biomedical Informatics, College of Medicine, The Ohio State Wexner Medical Center, Columbus, OH, USA
5
College of Nursing, The Ohio State Wexner Medical Center, Columbus, OH, USA
resectable PDAC are receiving chemotherapy and/or chemoradiation therapy (CRT) prior to surgical resection, a concept known as neoadjuvant therapy (NT) [3]. Since up to half of patients with PDAC are unable to receive adjuvant therapy following pancreatectomy [4, 5] NT maximizes the likelihood of patients receiving all components of multimodality therapy which is critical for optimizing long-term survival outcomes [6, 7]. NT also increases th
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