Expanded validation of the EPIC bowel and urinary domains for use in women with gynecologic cancer undergoing postoperative radiotherapy

Karen M. Gil, Stephanie L. Pugh, Ann H. Klopp, Anamaria R. Yeung, Lari Wenzel, Shannon N. Westin, David K. Gaffney, William Small, Spencer Thompson, Desiree E. Doncals, Guilherme H.C. Cantuaria, Brian P. Yaremko, Amy Chang, Vijayananda Kundapur, Dasarahally S. Mohan, Michael L. Haas, Yong Bae Kim, Catherine Lowrie Ferguson, Snehal Deshmukh, Lisa A. Kachnic & 1 others Deborah W. Bruner

Research output: Contribution to journalArticle

Abstract

Objective: Women with endometrial or cervical cancer at risk for recurrence receive postoperative radiation therapy (RT). A patient reported outcomes (PRO) instrument to assess bowel and urinary toxicities is the Expanded Prostate Cancer Index Composite (EPIC), which has been validated in men with prostate cancer. As this instrument specifically measures bowel toxicity and the degree to which this is a problem, it was used in NRG Oncology/RTOG 1203 to compare intensity modulated RT (IMRT) to standard RT. This paper reports on the expanded validation of EPIC for use in women receiving pelvic RT. Methods: In addition to the EPIC bowel domain, urinary toxicity (EPIC urinary domain), patient reported bowel toxicities (PRO-CTCAE) and quality of life (Functional Assessment of Cancer Therapy (FACT)) were completed before, during and after treatment. Sensitivity, reliability and concurrent validity were assessed. Results: Mean bowel and urinary scores among 278 women enrolled were significantly worse during treatment and differed between groups. Acceptable to good reliability for bowel and urinary domain scores were obtained at all time points with the exception of one at baseline. Correlations between function and bother scores within the bowel and urinary domains were consistently stronger than those across domains. Correlations between bowel domain scores and PRO-CTCAE during treatment were stronger than those with the FACT. Conclusion: Correlations within and among the instruments indicate EPIC bowel and urinary domains are measuring conceptually discrete components of health. These EPIC domains are valid, reliable and sensitive instruments to measure PRO among women undergoing pelvic radiation.

Original languageEnglish (US)
Pages (from-to)183-188
Number of pages6
JournalGynecologic Oncology
Volume154
Issue number1
DOIs
StatePublished - Jul 1 2019

Fingerprint

Prostatic Neoplasms
Radiotherapy
Neoplasms
Therapeutics
Endometrial Neoplasms
Reproducibility of Results
Uterine Cervical Neoplasms
Quality of Life
Radiation
Recurrence
Patient Reported Outcome Measures
Health

Keywords

  • Bowel and urinary toxicity
  • Cervical and endometrial cancer
  • Patient reported outcomes
  • Pelvic radiation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Expanded validation of the EPIC bowel and urinary domains for use in women with gynecologic cancer undergoing postoperative radiotherapy. / Gil, Karen M.; Pugh, Stephanie L.; Klopp, Ann H.; Yeung, Anamaria R.; Wenzel, Lari; Westin, Shannon N.; Gaffney, David K.; Small, William; Thompson, Spencer; Doncals, Desiree E.; Cantuaria, Guilherme H.C.; Yaremko, Brian P.; Chang, Amy; Kundapur, Vijayananda; Mohan, Dasarahally S.; Haas, Michael L.; Kim, Yong Bae; Ferguson, Catherine Lowrie; Deshmukh, Snehal; Kachnic, Lisa A.; Bruner, Deborah W.

In: Gynecologic Oncology, Vol. 154, No. 1, 01.07.2019, p. 183-188.

Research output: Contribution to journalArticle

Gil, KM, Pugh, SL, Klopp, AH, Yeung, AR, Wenzel, L, Westin, SN, Gaffney, DK, Small, W, Thompson, S, Doncals, DE, Cantuaria, GHC, Yaremko, BP, Chang, A, Kundapur, V, Mohan, DS, Haas, ML, Kim, YB, Ferguson, CL, Deshmukh, S, Kachnic, LA & Bruner, DW 2019, 'Expanded validation of the EPIC bowel and urinary domains for use in women with gynecologic cancer undergoing postoperative radiotherapy', Gynecologic Oncology, vol. 154, no. 1, pp. 183-188. https://doi.org/10.1016/j.ygyno.2019.04.682
Gil, Karen M. ; Pugh, Stephanie L. ; Klopp, Ann H. ; Yeung, Anamaria R. ; Wenzel, Lari ; Westin, Shannon N. ; Gaffney, David K. ; Small, William ; Thompson, Spencer ; Doncals, Desiree E. ; Cantuaria, Guilherme H.C. ; Yaremko, Brian P. ; Chang, Amy ; Kundapur, Vijayananda ; Mohan, Dasarahally S. ; Haas, Michael L. ; Kim, Yong Bae ; Ferguson, Catherine Lowrie ; Deshmukh, Snehal ; Kachnic, Lisa A. ; Bruner, Deborah W. / Expanded validation of the EPIC bowel and urinary domains for use in women with gynecologic cancer undergoing postoperative radiotherapy. In: Gynecologic Oncology. 2019 ; Vol. 154, No. 1. pp. 183-188.
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abstract = "Objective: Women with endometrial or cervical cancer at risk for recurrence receive postoperative radiation therapy (RT). A patient reported outcomes (PRO) instrument to assess bowel and urinary toxicities is the Expanded Prostate Cancer Index Composite (EPIC), which has been validated in men with prostate cancer. As this instrument specifically measures bowel toxicity and the degree to which this is a problem, it was used in NRG Oncology/RTOG 1203 to compare intensity modulated RT (IMRT) to standard RT. This paper reports on the expanded validation of EPIC for use in women receiving pelvic RT. Methods: In addition to the EPIC bowel domain, urinary toxicity (EPIC urinary domain), patient reported bowel toxicities (PRO-CTCAE) and quality of life (Functional Assessment of Cancer Therapy (FACT)) were completed before, during and after treatment. Sensitivity, reliability and concurrent validity were assessed. Results: Mean bowel and urinary scores among 278 women enrolled were significantly worse during treatment and differed between groups. Acceptable to good reliability for bowel and urinary domain scores were obtained at all time points with the exception of one at baseline. Correlations between function and bother scores within the bowel and urinary domains were consistently stronger than those across domains. Correlations between bowel domain scores and PRO-CTCAE during treatment were stronger than those with the FACT. Conclusion: Correlations within and among the instruments indicate EPIC bowel and urinary domains are measuring conceptually discrete components of health. These EPIC domains are valid, reliable and sensitive instruments to measure PRO among women undergoing pelvic radiation.",
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T1 - Expanded validation of the EPIC bowel and urinary domains for use in women with gynecologic cancer undergoing postoperative radiotherapy

AU - Gil, Karen M.

AU - Pugh, Stephanie L.

AU - Klopp, Ann H.

AU - Yeung, Anamaria R.

AU - Wenzel, Lari

AU - Westin, Shannon N.

AU - Gaffney, David K.

AU - Small, William

AU - Thompson, Spencer

AU - Doncals, Desiree E.

AU - Cantuaria, Guilherme H.C.

AU - Yaremko, Brian P.

AU - Chang, Amy

AU - Kundapur, Vijayananda

AU - Mohan, Dasarahally S.

AU - Haas, Michael L.

AU - Kim, Yong Bae

AU - Ferguson, Catherine Lowrie

AU - Deshmukh, Snehal

AU - Kachnic, Lisa A.

AU - Bruner, Deborah W.

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Objective: Women with endometrial or cervical cancer at risk for recurrence receive postoperative radiation therapy (RT). A patient reported outcomes (PRO) instrument to assess bowel and urinary toxicities is the Expanded Prostate Cancer Index Composite (EPIC), which has been validated in men with prostate cancer. As this instrument specifically measures bowel toxicity and the degree to which this is a problem, it was used in NRG Oncology/RTOG 1203 to compare intensity modulated RT (IMRT) to standard RT. This paper reports on the expanded validation of EPIC for use in women receiving pelvic RT. Methods: In addition to the EPIC bowel domain, urinary toxicity (EPIC urinary domain), patient reported bowel toxicities (PRO-CTCAE) and quality of life (Functional Assessment of Cancer Therapy (FACT)) were completed before, during and after treatment. Sensitivity, reliability and concurrent validity were assessed. Results: Mean bowel and urinary scores among 278 women enrolled were significantly worse during treatment and differed between groups. Acceptable to good reliability for bowel and urinary domain scores were obtained at all time points with the exception of one at baseline. Correlations between function and bother scores within the bowel and urinary domains were consistently stronger than those across domains. Correlations between bowel domain scores and PRO-CTCAE during treatment were stronger than those with the FACT. Conclusion: Correlations within and among the instruments indicate EPIC bowel and urinary domains are measuring conceptually discrete components of health. These EPIC domains are valid, reliable and sensitive instruments to measure PRO among women undergoing pelvic radiation.

AB - Objective: Women with endometrial or cervical cancer at risk for recurrence receive postoperative radiation therapy (RT). A patient reported outcomes (PRO) instrument to assess bowel and urinary toxicities is the Expanded Prostate Cancer Index Composite (EPIC), which has been validated in men with prostate cancer. As this instrument specifically measures bowel toxicity and the degree to which this is a problem, it was used in NRG Oncology/RTOG 1203 to compare intensity modulated RT (IMRT) to standard RT. This paper reports on the expanded validation of EPIC for use in women receiving pelvic RT. Methods: In addition to the EPIC bowel domain, urinary toxicity (EPIC urinary domain), patient reported bowel toxicities (PRO-CTCAE) and quality of life (Functional Assessment of Cancer Therapy (FACT)) were completed before, during and after treatment. Sensitivity, reliability and concurrent validity were assessed. Results: Mean bowel and urinary scores among 278 women enrolled were significantly worse during treatment and differed between groups. Acceptable to good reliability for bowel and urinary domain scores were obtained at all time points with the exception of one at baseline. Correlations between function and bother scores within the bowel and urinary domains were consistently stronger than those across domains. Correlations between bowel domain scores and PRO-CTCAE during treatment were stronger than those with the FACT. Conclusion: Correlations within and among the instruments indicate EPIC bowel and urinary domains are measuring conceptually discrete components of health. These EPIC domains are valid, reliable and sensitive instruments to measure PRO among women undergoing pelvic radiation.

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KW - Cervical and endometrial cancer

KW - Patient reported outcomes

KW - Pelvic radiation

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