Patient-clinician symptom agreement before and after radiotherapy for prostate cancer: results from the randomized HYPO-RT-PC study
In brief
Clinicians consistently underestimate urinary and bowel side effects after prostate radiotherapy
In a sub-study of 1,180 men from the HYPO-RT-PC trial, patient-reported urinary and bowel symptoms were regularly rated lower by clinicians at baseline and up to four years post-treatment, while sexual function was over-reported. Correlations between the two assessments were weak to moderate, indicating poor agreement and supporting routine use of patient-reported outcomes for accurate symptom monitoring.
- Journal
- Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Q1)
- Published
- 13 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ulrika Rönningås, Lars Beckman, Anna-Karin Wennstig, Per Fransson
- PMID
- 42732820
- DOI
- 10.1016/j.radonc.2026.111780
Why clinicians should know about it
- Picked for Urology (top studies of the week, 20 September 2026): Patient-reported outcomes, prostate radiotherapy symptom monitoring
Abstract
INTRODUCTION: Patient-reported outcome measures are recommended for monitoring treatment-related symptoms during radiotherapy (RT) for prostate cancer (PC). However, agreement between patient- and clinician-reported symptoms is often low. This study aimed to evaluate agreement between patient- and clinician-reported symptoms before and after radiotherapy for prostate cancer. MATERIALS AND METHODS: This sub-study of the HYPO-RT-PC trial included 1,180 men with PC randomized to conventional (2.0 Gy × 39 fx) or ultra-hypofractionated (6.1 Gy × 7 fx) RT between 2005 and 2015. Urinary, bowel, and sexual symptoms were assessed using the Prostate Cancer Symptom Scale questionnaire at baseline, at the end of RT, and at 1, 2, and 4 years post-treatment; clinicians evaluated symptoms at the same intervals using the Radiation Therapy Oncology Group scale. RESULTS: At each follow-up, 580-910 paired assessments were analyzed. Spearman's correlation between patient and clinician ratings ranged from -0.091 to 0.750. Clinicians consistently underrated urinary and bowel symptoms, overrated sexual activity, but results for erectile dysfunction were inconsistent. CONCLUSION: Agreement between patient- and clinician-reported RT-related symptoms was generally poor. These discrepancies highlight the limitations of relying solely on clinician assessment. They also underscore the need to integrate patient-reported outcome measures systematically into clinical practice and research to ensure accurate symptom monitoring and patient-centered care.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.