Impact of Gastrointestinal Side Effects on Patients’ Reported Quality of Life Trajectories after Radiotherapy for Prostate Cancer: Data from the Prospective, Observational Pros-IT CNR Study

Abstract

Radiotherapy (RT) represents an important therapeutic option for the treatment of localized prostate cancer. The aim of the current study is to examine trajectories in patients’ reported quality of life (QoL) aspects related to bowel function and bother, considering data from the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study, analyzed with growth mixture models. Data for patients who underwent RT, either associated or not associated with androgen deprivation therapy, were considered. QoL outcomes were assessed over a 2-year period from the diagnosis, using the Italian version of the University of California Los Angeles-Prostate Cancer Index (Italian-UCLA-PCI). Three trajectories were identified for the bowel function; having three or more comorbidities and the use of 3D-CRT technique for RT were associated with the worst trajectory (OR = 3.80, 95% CI 2.04–7.08; OR = 2.17, 95% CI 1.22–3.87, respectively). Two trajectories were identified for the bowel bother scores; diabetes and the non-Image guided RT method were associated with being in the worst bowel bother trajectory group (OR = 1.69, 95% CI 1.06–2.67; OR = 2.57, 95% CI 1.70–3.86, respectively). The findings from this study suggest that the absence of comorbidities and the use of intensity modulated RT techniques with image guidance are related with a better tolerance to RT in terms of bowel side effects.

Early results of PRO-EPI: PROspective multicenter observational study on elective pelvic nodes irradiation in patients with intermediate/high/very high-risk non-metastatic prostate cancer submitted to radical, adjuvant, or salvage radiotherapy with or without concomitant androgen deprivation therapy

“…Statistically significant differences were seen in QoL at the time of recruitment between patients who had previously undergone surgery and those who were candidates for exclusive RT treatment, as already reported in previous experiences ( 32 ).…”

Radiosensitization of PC3 Prostate Cancer Cells by 5-Thiocyanato-2′-deoxyuridine

“…Radiation therapies are commonly used in the management of prostate cancer since it is highly curable with radiation [25,26]. RT treatment, in this case, is also associated with an acceptable toxicity [27]. Nevertheless, the possible advantages of radiosensitization might allow dose de-escalation with the consequent benefits in terms of toxicity reduction.…”

Patient-Factors Influencing the 2-Year Trajectory of Mental and Physical Health in Prostate Cancer Patients

“…For each individual, the probability of belonging to each identified class is estimated on the bases of observed data, and participants are assigned to the group with the higher posterior probability, considering also the possible contribution of covariates [ 22 ]. SAS Proc Traj was used to identify the subgroups of participants with similar QoL trajectories [ 23 , 24 ], and the following steps were considered: the optimal number of groups was identified by fitting several models ranging from single to 5-group models; the shape of the trajectories was identified considering polynomials of varying degrees for each group, starting with a cubic specification, and then dropping non-significant polynomial terms; The model fit statistics (Bayesian Information Criterion (BIC)), the value of group membership probability and the average posterior probability (entropy) were considered to identify the best model: the magnitude of the difference in the BIC (2ΔBIC > 10) was used to choose between less or more complex models. the analysis aimed to identify groups including at least 5% of the population; the average posterior probability of membership was ascertained for each group; values greater than 0.7 indicate adequate internal reliability.…”