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

FRANCO, Pierfrancesco;
2015-01-01

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.
2015
116
2
185
191
www.elsevier.com/locate/radonc
Acute urinary toxicity; Dose-volume constraints; Modelling; Prostate cancer; Oncology; Radiology, Nuclear Medicine and Imaging; Hematology
Cozzarini, Cesare; Rancati, Tiziana; Carillo, Viviana; Civardi, Francesco; Garibaldi, Elisabetta; Franco, Pierfrancesco; Avuzzi, Barbara; Esposti, Claudio Degli; Girelli, Giuseppe; Iotti, Cinzia; Palorini, Federica; Vavassori, Vittorio; Valdagni, Riccardo; Fiorino, Claudio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1527415
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