Background: Baseline urinary incontinence (UI) strongly modulates UI recovery after adjuvant/salvage radiotherapy (ART/SRT), inducing clinicians to postpone it “as much as possible”, maximizing UI recovery but possibly reducing efficacy. This series aims to analyze the trend of UI recovery and its predictors at radiotherapy start. Methods: A population of 408 patients treated with ART/SRT enrolled in a cohort study (ClinicalTrials.gov #NCT02803086) aimed at developing predictive models of radiation-induced toxicities. Self-reported UI and personality traits, evaluated by means of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) and Eysenck Personality Questionnaire - Revised (EPQ-R) questionnaires, were assessed at ART/SRT start. Several endpoints based on baseline ICIQ-SF were investigated: frequency and amount of urine loss (ICIQ3 and ICIQ4, respectively), “objective” UI (ICIQ3 + 4), “subjective” UI (ICIQ5), and “TOTAL” UI (ICIQ3 +4 + 5). The relationship between each endpoint and time from prostatectomy to radiotherapy (TTRT) was investigated. The association between clinical and personality variables and each endpoint was tested by uni- and multivariable logistic regression. Results: TTRT was the strongest predictor for all endpoints (p-values ≤ 0.001); all scores improved between 4 and 8 months after prostatectomy, without any additional long-term recovery. Neuroticism independently predicted subjective UI, TOTAL UI, and daily frequency. Conclusions: Early UI recovery mostly depends on TTRT with no further improvement after 8 months from prostatectomy. Higher levels of neuroticism may overestimate UI.
Bresolin et al. Two-Year Incontinence After Post-prostatectomy Radiotherapy were entered into a backward stepwise multi-variable logistic regression analysis. Lastly, the goodness of fit and model calibration were evaluated and internally validated. Results: Patients without symptoms at baseline experienced (a), (b), and/or (c) within 2 years in 41/130 (32%), 40/192 (21%), and 41/129 (32%) of the cases, respectively. EQD2 for α/β = 0.8Gy was the best dose metric associated with PRUI. Multi-variable analysis identified baseline incontinence levels as the strongest predictor for all endpoints (p < 0.006). Both FREQUENCY and OBJECTIVE were significantly influenced also by EQD2(α/β = 0.8Gy). The goodness of fit was excellent, as was the calibration; internal calibration confirmed apparent performance. Conclusion: Baseline mild urinary incontinence symptoms strongly modulate the 2-year risk of PRUI. In addition, FREQUENCY is characterized by a marked dose-effect relationship also influencing the trend of OBJECTIVE, with results more reliable than AMOUNT as an objective index. A strong impact of fractionation on severe PRUI after post-prostatectomy radiotherapy also emerged.
Purpose: To compare gross tumour volume (GTV) in oropharynx carcinomas using different intelligent imaging software and to evaluate which method is more reliable for tumour volume definition in comparison with 3D ProSoma software. Material and methods: We retrospectively studied 32 patients with histopathologically confirmed oropharynx carcinomas on dual-source computed tomography (CT) (all patients underwent multislice CT examination after applying 75 ml iodinated non-ionic contrast media). One radiologist calculated the tumour volume-manually measuring tumour length (L), width (W), and height (H)-and then calculated the tumour volume using the formula 0.5236 × L × W × H. The other radiologist used the syngo.CT-Liver-Analysis software to calculate the tumour volumes. Both volume measuring methods were compared with the 3D ProSoma software, which is used by radiotherapists to calculate tumour volumes. Graphpad Prism software was used for statistical data. Results: syngo.CT-Liver-Analysis software for gross tumour volume determination has greater reliability than the standard manual method with Syngo Plaza in comparison with the 3D ProSoma software. Conclusions: syngo.CT-Liver-Analysis software is a reliable tool for GTV calculation, with a high correlation score, like that of radiotherapeutic 3D ProSoma software.
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