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Different methods, such as visual observance of metal-ion indicators, spectroscopic techniques, and potentiometric methods, can determine the endpoint of an EDTA titration.
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Pelvic radiation disease, or chronic radiation-induced consequences, is under recognized. Standardized assessment and treatment algorithms are needed for gastrointestinal symptoms to improve patient outcomes.

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Area of Science:

  • Oncology
  • Radiotherapy
  • Patient Outcomes

Background:

  • Chronic radiation-induced consequences of pelvic radiotherapy are under-recognized by healthcare professionals and under-reported by patients.
  • Gastrointestinal symptoms are often not routinely assessed and may be undertreated due to lack of causal association with radiotherapy.
  • Current assessment tools may not fully capture patient-reported issues like urgency, leading to limited clinician-patient concordance.

Purpose of the Study:

  • To review current literature on the recognition and management of chronic radiation-induced gastrointestinal symptoms following pelvic radiotherapy.
  • To highlight the limitations in current outcome measurement and assessment tools for pelvic radiation disease.
  • To emphasize the need for standardized approaches in screening and treating these late effects.

Main Methods:

  • A literature search was conducted in Ovid Medline and Ovid Embase for articles published between 2016 and April 2018.
  • Eleven articles were selected for review, focusing on patient-reported outcome measures and clinical symptom grading.
  • Analysis of existing tools for assessing treatment consequences and clinician-patient concordance.

Main Results:

  • A wide range of patient-reported outcome measure instruments are utilized, but clinical symptom grading is limited.
  • Existing tools may not capture all patient-important issues, such as urgency, impacting outcome assessment.
  • Limited concordance exists between clinicians and patients in assessing treatment outcomes.
  • Initiatives for improved communication and new techniques to limit radiation to healthy tissue are emerging.

Conclusions:

  • Nonstandardized outcome measurement hinders the aggregation of toxicity and patient outcomes across clinical trials.
  • Standardized screening and treatment algorithms for gastrointestinal symptoms are crucial for systematic identification and management of late treatment effects.
  • Developing standardized approaches will improve the systematic location and treatment of gastrointestinal late effects of pelvic radiotherapy.