Purpose A prospective trial started in 2010, aiming at developing models for urinary toxicity and erectile dysfunction after radiotherapy for prostate cancer. This analysis is finalised at highlighting correlations between clinical/dosimetric factors and acute urinary specific symptoms, as measured by single questions of the International Prostate Symptom Score (IPSS). Materials/methods IPSS was prospectively collected before and at the end of radiotherapy; absolute weekly bladder dose-surface histograms (DSHw) were chosen as dosimetric descriptors. Relevant clinical factors were prospectively gathered. Backward feature selection was used to identify variables to be included in logistic models for moderate-severe (scores ≥ 4) urinary symptoms. Results Complete data of 262 patients (120 conventional fractionation, 142 hypofractionation) were available. Smoking was a strong predictor for feeling of incomplete emptying, frequency, intermittency, urgency and straining; neoadjuvant hormonal therapy and use of antihypertensive drugs were risk factors for intermittency and weak stream, respectively. The baseline score was a major predictor for all symptoms with the exception of intermittency. DSHw were correlated to increased risk of frequency, intermittency, urgency and nocturia. Most models showed moderate-high discrimination (AUC 0.60-0.79). Conclusions Smoking and other clinical and dosimetric factors predict for specific moderate-severe acute urinary symptoms; baseline condition heavily modulated the risk in most endpoints.

Multi-variable models predicting specific patient-reported acute urinary symptoms after radiotherapy for prostate cancer : results of a cohort study / C. Cozzarini, T. Rancati, V. Carillo, F. Civardi, E. Garibaldi, P. Franco, B. Avuzzi, C.D. Esposti, G. Girelli, C. Iotti, F. Palorini, V. Vavassori, R. Valdagni, C. Fiorino. - In: RADIOTHERAPY AND ONCOLOGY. - ISSN 0167-8140. - 116:2(2015 Aug), pp. 185-191. [10.1016/j.radonc.2015.07.048]

Multi-variable models predicting specific patient-reported acute urinary symptoms after radiotherapy for prostate cancer : results of a cohort study

T. Rancati;B. Avuzzi;F. Palorini;R. Valdagni;
2015-08

Abstract

Purpose A prospective trial started in 2010, aiming at developing models for urinary toxicity and erectile dysfunction after radiotherapy for prostate cancer. This analysis is finalised at highlighting correlations between clinical/dosimetric factors and acute urinary specific symptoms, as measured by single questions of the International Prostate Symptom Score (IPSS). Materials/methods IPSS was prospectively collected before and at the end of radiotherapy; absolute weekly bladder dose-surface histograms (DSHw) were chosen as dosimetric descriptors. Relevant clinical factors were prospectively gathered. Backward feature selection was used to identify variables to be included in logistic models for moderate-severe (scores ≥ 4) urinary symptoms. Results Complete data of 262 patients (120 conventional fractionation, 142 hypofractionation) were available. Smoking was a strong predictor for feeling of incomplete emptying, frequency, intermittency, urgency and straining; neoadjuvant hormonal therapy and use of antihypertensive drugs were risk factors for intermittency and weak stream, respectively. The baseline score was a major predictor for all symptoms with the exception of intermittency. DSHw were correlated to increased risk of frequency, intermittency, urgency and nocturia. Most models showed moderate-high discrimination (AUC 0.60-0.79). Conclusions Smoking and other clinical and dosimetric factors predict for specific moderate-severe acute urinary symptoms; baseline condition heavily modulated the risk in most endpoints.
Acute urinary toxicity; Dose-volume constraints; Modelling; Prostate cancer; Oncology; Radiology, Nuclear Medicine and Imaging; Hematology; Medicine (all)
Settore MED/36 - Diagnostica per Immagini e Radioterapia
RADIOTHERAPY AND ONCOLOGY
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/426681
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