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.
Patient-reported urinary incontinence after radiotherapy for prostate cancer: Quantifying the dose-effect / C. Cozzarini, T. Rancati, F. Palorini, B. Avuzzi, E. Garibaldi, D. Balestrini, D. Cante, F. Munoz, P. Franco, G. Girelli, C. Sini, V. Vavassori, R. Valdagni, C. Fiorino. - In: RADIOTHERAPY AND ONCOLOGY. - ISSN 0167-8140. - 125:1(2017 Oct), pp. 101-106.
|Titolo:||Patient-reported urinary incontinence after radiotherapy for prostate cancer: Quantifying the dose-effect|
VALDAGNI, RICCARDO (Penultimo)
|Parole Chiave:||incontinence; predictive models; prostate cancer; radiotherapy; hematology; oncology; radiology, nuclear medicine and imaging|
|Settore Scientifico Disciplinare:||Settore MED/36 - Diagnostica per Immagini e Radioterapia|
|Data di pubblicazione:||ott-2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.radonc.2017.07.029|
|Appare nelle tipologie:||01 - Articolo su periodico|