TY - JOUR
T1 - Multi-variable models of large International Prostate Symptom Score worsening at the end of therapy in prostate cancer radiotherapy
AU - Palorini, Federica
AU - Rancati, Tiziana
AU - Cozzarini, Cesare
AU - Improta, Ilaria
AU - Carillo, Viviana
AU - Avuzzi, Barbara
AU - Casanova Borca, Valeria
AU - Botti, Andrea
AU - Degli Esposti, Claudio
AU - Franco, Pierfrancesco
AU - Garibaldi, Elisabetta
AU - Girelli, Giuseppe
AU - Iotti, Cinzia
AU - Maggio, Angelo
AU - Palombarini, Marcella
AU - Pierelli, Alessio
AU - Pignoli, Emanuele
AU - Vavassori, Vittorio
AU - Valdagni, Riccardo
AU - Fiorino, Claudio
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Purpose/objective Prospectively assessing clinical/dosimetry factors affecting the acute worsening of urinary functionality after radiotherapy for prostate cancer. Material/methods DUE01 population was considered, including patients treated with conventional or moderate hypo-fractionation (2.2-2.7 Gy/fr). Relevant clinical factors were collected, urinary symptoms were self-reported through the International Prostate Symptom Score (IPSS) before and at the end of radiotherapy; while absolute weekly dose-surface histograms (DSHw) were chosen as dosimetry descriptors. An IPSS increase of at least 10 and 15 points (ΔIPSS ≥ 10 and ΔIPSS ≥ 15) were chosen as endpoints. Patients with baseline IPSS > 20 were excluded. Relevant factors were chosen through a bootstrap-based in silico methodology. Results Complete information was available for 380 patients: 77/380 (20%) and 28/380 (7%) with ΔIPSS ≥ 10 and ΔIPSS ≥ 15, respectively. Neoadjuvant hormone was protective (OR = 0.49 and 0.69). DSHw at 8.5 Gy/week and 12 Gy/week were risk factors, with additional risk for patients who use cardiovascular drugs and anti-hypercholesterolemia drugs. In the hypo-fractionated subgroup (n = 209) the role of cardiovascular drugs (OR = 2.16) for ΔIPSS ≥ 10 and anti-hypercholesterolemia drugs (OR = 2.80) for ΔIPSS ≥ 15, together with DSHw (10 Gy/week and 12.5 Gy/week, respectively), was confirmed. Conclusion Current study shows a dose-surface/volume effect for acute large worsening of urinary functionality; several clinical variables largely impact the risk and especially all the factors related with vascular diseases.
AB - Purpose/objective Prospectively assessing clinical/dosimetry factors affecting the acute worsening of urinary functionality after radiotherapy for prostate cancer. Material/methods DUE01 population was considered, including patients treated with conventional or moderate hypo-fractionation (2.2-2.7 Gy/fr). Relevant clinical factors were collected, urinary symptoms were self-reported through the International Prostate Symptom Score (IPSS) before and at the end of radiotherapy; while absolute weekly dose-surface histograms (DSHw) were chosen as dosimetry descriptors. An IPSS increase of at least 10 and 15 points (ΔIPSS ≥ 10 and ΔIPSS ≥ 15) were chosen as endpoints. Patients with baseline IPSS > 20 were excluded. Relevant factors were chosen through a bootstrap-based in silico methodology. Results Complete information was available for 380 patients: 77/380 (20%) and 28/380 (7%) with ΔIPSS ≥ 10 and ΔIPSS ≥ 15, respectively. Neoadjuvant hormone was protective (OR = 0.49 and 0.69). DSHw at 8.5 Gy/week and 12 Gy/week were risk factors, with additional risk for patients who use cardiovascular drugs and anti-hypercholesterolemia drugs. In the hypo-fractionated subgroup (n = 209) the role of cardiovascular drugs (OR = 2.16) for ΔIPSS ≥ 10 and anti-hypercholesterolemia drugs (OR = 2.80) for ΔIPSS ≥ 15, together with DSHw (10 Gy/week and 12.5 Gy/week, respectively), was confirmed. Conclusion Current study shows a dose-surface/volume effect for acute large worsening of urinary functionality; several clinical variables largely impact the risk and especially all the factors related with vascular diseases.
KW - Dose-volume effects
KW - Prostate cancer
KW - Radiotherapy
KW - Urinary toxicity
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U2 - 10.1016/j.radonc.2015.11.036
DO - 10.1016/j.radonc.2015.11.036
M3 - Article
AN - SCOPUS:84959533025
VL - 118
SP - 92
EP - 98
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 1
ER -