Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 101-106 |
| Number of pages | 6 |
| Journal | Radiotherapy and Oncology |
| Volume | 125 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2017 |
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Patient-reported urinary incontinence after radiotherapy for prostate cancer: Quantifying the dose-effect. / Cozzarini, C; Rancati, T; Palorini, F; Avuzzi, B; Garibaldi, E; Balestrini, D; Cante, D; Munoz, F; Franco, P; Girelli, G; Sini, C; Vavassori, V; Valdagni, R; Fiorino, C.
In: Radiotherapy and Oncology, Vol. 125, No. 1, 2017, p. 101-106.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Patient-reported urinary incontinence after radiotherapy for prostate cancer: Quantifying the dose-effect
AU - Cozzarini, C
AU - Rancati, T
AU - Palorini, F
AU - Avuzzi, B
AU - Garibaldi, E
AU - Balestrini, D
AU - Cante, D
AU - Munoz, F
AU - Franco, P
AU - Girelli, G
AU - Sini, C
AU - Vavassori, V
AU - Valdagni, R
AU - Fiorino, C
PY - 2017
Y1 - 2017
N2 - Background and purpose: Urinary incontinence following radiotherapy (RT) for prostate cancer (PCa) has a relevant impact on patient's quality of life. The aim of the study was to assess the unknown dose-effect relationship for late patient-reported urinary incontinence (LPRUI). Methods and materials: Patients were enrolled within the multi-centric study DUE01. Clinical and dosimetry data including the prescribed 2. Gy equivalent dose (EQD2) were prospectively collected. LPRUI was evaluated through the ICIQ-SF questionnaire filled in by the patients at RT start/end and therefore every 6. months. Patients were treated with conventional (74-80. Gy, 1.8-2. Gy/fr) or moderately hypo-fractionated RT (65-75.2. Gy, 2.2-2.7. Gy/fr) in 5 fractions/week with intensity-modulated radiotherapy. Six different end-points of 3-year LPRUI, including or not patient's perception (respectively, subjective and objective end-points), were considered. Multivariable logistic models were developed for each end-point. Results: Data of 298 patients were analyzed. The incidence of the most severe end-point (ICIQ-SF. > . 12) was 5.1%. EQD2 calculated with alpha-beta = 0.8. Gy showed the best performance in fitting data: the risk of LPRUI markedly increased for EQD2. > . 80. Gy. Previous abdominal/pelvic surgery and previous TURP were the clinical factors more significantly predictive of LPRUI. Models showed excellent performances in terms of goodness-of-fit and calibration, confirmed by bootstrap-based internal validation. When included in the analyses, baseline symptoms were a major predictor for 5 out of six end-points. Conclusions: LPRUI after RT for PCa dramatically depends on EQD2 and few clinical factors. Results are consistent with a larger than expected impact of moderate hypo-fractionation on the risk of LPRUI. As expected, baseline symptoms, as captured by ICIQ-SF, are associated to an increased risk of LPRUI. © 2017 Elsevier B.V.
AB - Background and purpose: Urinary incontinence following radiotherapy (RT) for prostate cancer (PCa) has a relevant impact on patient's quality of life. The aim of the study was to assess the unknown dose-effect relationship for late patient-reported urinary incontinence (LPRUI). Methods and materials: Patients were enrolled within the multi-centric study DUE01. Clinical and dosimetry data including the prescribed 2. Gy equivalent dose (EQD2) were prospectively collected. LPRUI was evaluated through the ICIQ-SF questionnaire filled in by the patients at RT start/end and therefore every 6. months. Patients were treated with conventional (74-80. Gy, 1.8-2. Gy/fr) or moderately hypo-fractionated RT (65-75.2. Gy, 2.2-2.7. Gy/fr) in 5 fractions/week with intensity-modulated radiotherapy. Six different end-points of 3-year LPRUI, including or not patient's perception (respectively, subjective and objective end-points), were considered. Multivariable logistic models were developed for each end-point. Results: Data of 298 patients were analyzed. The incidence of the most severe end-point (ICIQ-SF. > . 12) was 5.1%. EQD2 calculated with alpha-beta = 0.8. Gy showed the best performance in fitting data: the risk of LPRUI markedly increased for EQD2. > . 80. Gy. Previous abdominal/pelvic surgery and previous TURP were the clinical factors more significantly predictive of LPRUI. Models showed excellent performances in terms of goodness-of-fit and calibration, confirmed by bootstrap-based internal validation. When included in the analyses, baseline symptoms were a major predictor for 5 out of six end-points. Conclusions: LPRUI after RT for PCa dramatically depends on EQD2 and few clinical factors. Results are consistent with a larger than expected impact of moderate hypo-fractionation on the risk of LPRUI. As expected, baseline symptoms, as captured by ICIQ-SF, are associated to an increased risk of LPRUI. © 2017 Elsevier B.V.
U2 - 10.1016/j.radonc.2017.07.029
DO - 10.1016/j.radonc.2017.07.029
M3 - Article
VL - 125
SP - 101
EP - 106
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 1
ER -