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World J Clin Oncol. Mar 24, 2026; 17(3): 115774
Published online Mar 24, 2026. doi: 10.5306/wjco.v17.i3.115774
Published online Mar 24, 2026. doi: 10.5306/wjco.v17.i3.115774
Patient-reported outcome measures for technology assessment: A comparison between three-dimensional conformal and intensity-modulated radiotherapy in prostate cancer
Arantxa Mera, Gemma Sancho, Servicio de Oncología Radioterápica, Departamento de Medi
Olatz Garin, Yolanda Pardo, Montse Ferrer, Health Services Research Group, Hospital del Mar Research Institute, CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, Universitat Pompeu Fabra, Barcelona 08003, Catalonia, Spain
Àngels Pont, Health Services Research Group, Hospital del Mar Research Institute, CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, Barcelona 08003, Catalonia, Spain
Victor Macias, Servicio de Oncología Radioterápica, Hospital La Fe, Valencia 46026, Spain
Asuncion Hervas, Servicio de Oncología Radioterápica, Hospital Ramon y Cajal, Madrid 28034, Spain
Patricia Cabrera, Servicio de Oncología Radioterápica, Hospital Universitario Virgen del Rocío, Sevilla 41013, Andalucía, Spain
Ferrán Ferrer, Servicio de Oncología Radioterápica, Institut Català d’Oncologia, Departament de Ciències Clíniques, Facultat de Medicina, Universitat de Barcelona, Hospitalet del Llobregat 08908, Spain
Àlvar Roselló, Servicio de Oncología Radioterápica, Institut Català d’Oncologia, Girona 17007, Catalonia, Spain
Pilar Samper Ots, Servicio de Oncología Radioterápica, Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Hospital Rey Juan Car
María Elena García, Servicio de Oncología Radioterápica, Hospital Arnau Vilanova, Lleida 25198, Catalonia, Spain
Josep Jové-Teixidó, Servicio de Oncología Radioterápica, Institut Català d’Oncologia, Bada
Co-corresponding authors: Olatz Garin and Montse Ferrer.
Author contributions: Mera A, Sancho G, Garin O, and Ferrer M designed the study; Mera A, Sancho G, Macias V, Hervas A, Cabrera P, Ferrer F, Roselló À, Samper Ots P, García ME, Jové-Teixidó J, and Ferrer M contributed to patient treatment and follow-up; Mera A, Garin O, and Ferrer M drafted the manuscript; Garin O and Ferrer M contributed equally in this manuscript, as senior and junior PIs in the study, sharing responsibility in the contact and preparation of this manuscript and the revision and submission process as co-corresponding authors; Pont A was the biomedical statistician performing the main statistical analysis; Mera A, Sancho G, Garin O, Pont À, Pardo Y, Macias V, Hervas A, Cabrera P, Ferrer F, Roselló À, Samper Ots P, García ME, Jové-Teixidó J, and Ferrer M collected, analysed and interpreted the data; all authors critically revised, read the manuscript and approved the final version.
Supported by Instituto de Salud Carlos III (ISCIII) and European Union, No. PI21/00023; Fundación Científica de la Asociación Española Contra el Cáncer, No. PRYES223070FERR; and Departament de Recerca i Universitats, Generalitat de Catalunya, No. AGAUR 2021 SGR 00624.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Parc de Salut Mar, which encompasses the coordinating centre Hospital del Mar Research Institute (No. 2021/10183/I).
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: The authors declare no potential conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: The data supporting the results of this study are available from the corresponding author upon reasonable request at mferrer@researchmar.net.
Corresponding author: Montse Ferrer, PhD, Health Services Research Group, Hospital del Mar Research Institute, CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, Universitat Pompeu Fabra, Barcelona Biomedical Research Park, office 140.03 Carrer del Doctor Aiguader 88, First Floor, Barcelona 08003, Catalonia, Spain. mferrer@researchmar.net
Received: October 27, 2025
Revised: November 22, 2025
Accepted: January 28, 2026
Published online: March 24, 2026
Processing time: 149 Days and 19.7 Hours
Revised: November 22, 2025
Accepted: January 28, 2026
Published online: March 24, 2026
Processing time: 149 Days and 19.7 Hours
Core Tip
Core Tip: This study demonstrates the utility of patient-reported outcome measures in assessing technological advances in radiotherapy for localized prostate cancer. By comparing long-term quality-of-life outcomes between three-dimensional conformal radiotherapy and intensity-modulated radiotherapy, it reveals that intensity-modulated radiotherapy – especially when combined with image guidance and reduced margins – was associated with better preservation of urinary continence and bowel function. Conversely, hypofractionation and dose escalation may transiently worsen urinary symptoms. Patient-reported outcome measures capture nuances in patient-centred effects of radiotherapy innovations, supporting their inte