Nomograms to predict late urinary toxicity after prostate cancer radiotherapy

Mathiéu, Romain; Arango, Juan David Ospina; Beckendorf, V.; Delobel, Jean-Bernard; Messaï, T.; Chira, C.; Bossi, Alberto; Prisé, É. Le; Guérif, S.; Simon, Jean‐Marc; Dubray, Bernard; Jing-ci, Zhu; Lagrange, Jean‐Léon; Pommier, P.; Gnep, K.; Acosta, Oscar; Crevoisier, R. de

doi:10.1007/s00345-013-1146-8

Cited by 29 publications

(40 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…; dysuria) across all time points. Diabetes has already been reported to increase the likelihood of delayed radiationinduced urinary morbidity [9,10]. The impact, however, was not found by some others [7,8].…”

Section: Discussionmentioning

confidence: 98%

“…Examples include the protective effect of hypertension which was suggested to be associated to antihypertensive medication intake [7], and exacerbation of haematuria with anticoagulant intake [2,10].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have suggested the association of hypertension to treatmentrelated symptoms may relate to the medication intake [7] while Wedlake et al shown the reduction of treatment-related symptoms with the intake of statin and ACE [13] -therefore, the comorbidities were not included in the multivariate models. NIDDM, however, was included due to the impact previously shown [9,10]. The negative correlation between the bladder volume and the dosimetric factor PC1 is expected due to the inclusion of larger relative bladder volume in the high dose region in patients with smaller/empty bladder [30].…”

Section: Variable Selection and Multivariate Analysismentioning

confidence: 99%

“…Apart from the dosimetric factors [3][4][5][6], urinary symptoms have been demonstrated to be influenced by other comorbidities, including hypertension [7,8], diabetes [9,10] and baseline urinary symptoms [11,12]. There are suggestions that the intake of certain medications related has an impact on the interaction between radiation treatment and biological systems, which influences the expression of symptoms [10,13].…”

Section: Introductionmentioning

confidence: 99%

“…There are suggestions that the intake of certain medications related has an impact on the interaction between radiation treatment and biological systems, which influences the expression of symptoms [10,13]. Anti-hypertensive medication [5] and anticoagulants [10] were associated with a higher risk of acute and late urinary symptoms, respectively. The protective impact of angiotensin converting enzyme (ACE)-inhibitor (ACE) intake has been suggested in other organ systems [13].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya

Ebert

Bulsara

et al. 2015

Radiotherapy and Oncology

View full text Add to dashboard Cite

Urinary symptoms (frequency, incontinence, dysuria and haematuria) were prospectively assessed using LENT-SOMA to a median of 72 months. The endpoints assessed were prevalence (grade≥1) at the end of radiotherapy (representing acute symptoms), at 18-, 36-and 54-month follow-ups (representing late symptoms) and peak late incidence including only grade≥2. Impact of factors were assessed using multivariate logistic regression models with correction for over-optimism. Results: Baseline symptoms, non-insulin dependent diabetes mellitus, age and PC1 (correlated to the mean dose) impact symptoms at >1 timepoints. Associations at a single timepoint were found for cerebrovascular condition, ECOG status and non-steroidal anti-inflammatory drug intake. Peak incidence analysis shows the impact of baseline, bowel and cerebrovascular condition and smoking status. Conclusions:The prevalence and incidence analysis provide a complementary view for urinary symptom prediction. Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact.4

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Variable Selection and Multivariate Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya

Ebert

Bulsara

et al. 2015

Radiotherapy and Oncology

View full text Add to dashboard Cite

show abstract

Incidence of genitourinary complications following radiation therapy for localised prostate cancer

et al. 2022

View full text Add to dashboard Cite

Purpose Studies of genitourinary toxicity following radiotherapy for prostate cancer are mainly from high volume single institutions and the incidence and burden of treatment remain uncertain. Hence we determine the cumulative incidence of treatment-related genitourinary toxicity in patients with localised prostate cancer treated with primary external beam radiotherapy (EBRT) at a state population level. Methods We analysed data from a prospective population-based cohort, including hospital admission and cancer registry data, for men with localised prostate cancer who underwent primary EBRT without nodal irradiation between 1998 and 2019 in South Australia. The 10-year cumulative incidence of genitourinary toxicity requiring hospitalisation or procedures was determined. Clinical predictors of toxicity and the volume of admissions, non-operative, minor operative and major operative procedures were determined. Results All the included patients (n = 3350) had EBRT, with a median (IQR) of 74 Gy (70–78) in 37 fractions (35–39). The 10-year cumulative incidence of was 28.4% (95% CI 26.3–30.6) with a total of 2545 hospital admissions, including 1040 (41%) emergency and 1893 (74%) readmissions. The 10-year cumulative incidence of patients in this cohort requiring a urological operative procedure was 18% (95% CI 16.1–19.9), with a total of 106 (4.2%) non-operative, 1044 (41%) minor operative and 57 (2.2%) major operative urological procedures. Conclusions Genitourinary toxicity after radiotherapy for prostate cancer is common. Although there continue to be advancements in radiotherapy techniques, patients and physicians should be aware of the risk of late toxicity when considering EBRT.

show abstract

Predicting post-radiation genitourinary hospital admissions in patients with localised prostate cancer

et al. 2022

View full text Add to dashboard Cite

Purpose The risk of treatment-related toxicity is important for patients with localised prostate cancer to consider when deciding between treatment options. We developed a model to predict hospitalisation for radiation-induced genitourinary toxicity based on patient characteristics. Methods The prospective South Australian Prostate Cancer Clinical Outcomes registry was used to identify men with localised prostate cancer who underwent curative intent external beam radiotherapy (EBRT) between 1998 and 2019. Multivariable Cox proportional regression was performed. Model discrimination, calibration, internal validation and utility were assessed using C-statistics and area under ROC, calibration plots, bootstrapping, and decision curve analysis, respectively. Results There were 3,243 patients treated with EBRT included, of which 644 (20%) patients had a treated-related admission. In multivariable analysis, diabetes (HR 1.35, 95% CI 1.13–1.60, p < 0.001), smoking (HR 1.78, 95% CI 1.40–2.12, p < 0.001), and bladder outlet obstruction (BOO) without transurethral resection of prostate (TURP) (HR 7.49, 95% CI 6.18–9.08 p < 0.001) followed by BOO with TURP (HR 4.96, 95% CI 4.10–5.99 p < 0.001) were strong independent predictors of hospitalisation (censor-adjusted c-statistic = 0.80). The model was well-calibrated (AUC = 0.76). The global proportional hazards were met. In internal validation through bootstrapping, the model was reasonably discriminate at five (AUC 0.75) years after radiotherapy. Conclusions This is the first study to develop a predictive model for genitourinary toxicity requiring hospitalisation amongst men with prostate cancer treated with EBRT. Patients with localised prostate cancer and concurrent BOO may benefit from TURP before EBRT.

show abstract

Nomograms to predict late urinary toxicity after prostate cancer radiotherapy

Abstract: The first nomograms to predict late urinary toxicity but also specific urinary symptoms after prostate RT were generated, contributing to prostate cancer treatment decision.

Cited by 29 publications

References 23 publications

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Incidence of genitourinary complications following radiation therapy for localised prostate cancer

Predicting post-radiation genitourinary hospital admissions in patients with localised prostate cancer

Contact Info

Product

Resources

About