Worsening of 2-year patient-reported intestinal functionality after radiotherapy for prostate cancer including pelvic node irradiation. in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology / Radiother Oncol. 2024 Mar;192:110088. doi: 10.1016/j.radonc.2024.110088. Epub 2024 Jan 8.

2024
ASL Biella
AOU Alessandria
ASL Torino 4

Tipo pubblicazione

Journal Article

Autori/Collaboratori (24)Vedi tutti...

Gisella Di Muzio N
Radiotherapy, IRCCS San Raffaele Scientific Institute, Milano, Italy; Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy.
Cozzarini C
Radiotherapy, IRCCS San Raffaele Scientific Institute, Milano, Italy. Electronic address: cozzarini.cesare@hsr.it.
Fiorino C
Medical Physics, IRCCS San Raffaele Scientific Institute, Milano, Italy.

et alii...

Abstract

BACKGROUND AND PURPOSE: To quantify patient-reported 2-year intestinal toxicity (IT) from pelvic nodal irradiation (PNI) for prostate cancer. The association between baseline/acute symptoms and 2-year worsening was investigated. MATERIALS AND METHODS: Patient-reported IT was prospectively assessed through the Inflammatory Bowel Disease Questionnaire (IBDQ), filled in at baseline, radiotherapy mid-point and end, at 3 and 6 months and every 6 months until 5 years. Two-year deterioration of IBDQ scores relative to the Bowel Domain was investigated for 400 patients with no severe baseline symptoms and with questionnaires available at baseline, 2 years, RT mid-point and/or end and at least three follow-ups between 3 and 18 months. The significance of the 2-year differences from baseline was tested. The association between baseline values and ?(Acute) (the worst decline between baseline and RT mid-point/end) was investigated. RESULTS: In the IBDQ lower scores indicate worse symptoms. A significant (p < 0.0001) 2-year mean worsening, mostly in the range of -0.2/-0.4 points on a 1-7 scale, emerged excepting one question (IBDQ29, "nausea/feeling sick"). This decline was independent of treatment intent while baseline values were associated with 2-year absolute scores. The ?(Acute) largely modulated 2-year worsening: patients with ?(Acute) greater than the first quartile (Q1) and ?(Acute) less or equal than Q1 showed no/minimal and highly significant (p < 0.0001) deterioration, respectively. Rectal incontinence, urgency, frequency and abdominal pain showed the largest mean changes (-0.5/-1): risk of severe worsening (deemed to be of clinical significance if ? 2) was 3-5 fold higher in the ?(Acute) ? Q1 vs ?(Acute) > Q1 group (p < 0.0001). CONCLUSION: A modest but significant deterioration of two-year patient-reported intestinal symptoms from PNI compared to baseline was found. Patients experiencing more severe acute symptoms are at higher risk of symptom persistence at 2 years, with a much larger prevalence of clinically significant symptoms.

Accesso banca dati bibliografica

PMID : 38199284

DOI : 10.1016/j.radonc.2024.110088

Keywords

Prostate cancer; Pelvic node radiotherapy; Intestinal Toxicity; Late Toxicity; Quality of Life; Inflammatory Bowel Disease Questionnaire; Patient Reported Outcome Measures; Radiation Oncology; Inflammatory Bowel Diseases; Rectum/radiation effects; Pelvis/radiation effects; Prostatic Neoplasms/radiotherapy; Humans; Male;