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 midpoint 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 Delta 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 2year absolute scores. The Delta Acute largely modulated 2 -year worsening: patients with Delta Acute greater than the first quartile (Q1) and Delta 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 Delta Acute <= Q1 vs Delta 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.
Worsening of 2-year patient-reported intestinal functionality after radiotherapy for prostate cancer including pelvic node irradiation / Sanguineti, G.; Pavarini, M.; Munoz, F.; Magli, A.; Cante, D.; Garibaldi, E.; Gebbia, A.; Noris Chiorda, B.; Girelli, G.; Villa, E.; Faiella, A.; Magdalena Waskiewicz, J.; Avuzzi, B.; Pastorino, A.; Moretti, E.; Rago, L.; Statuto, T.; Gatti, M.; Rancati, T.; Valdagni, R.; Luigi Vavassori, V.; Gisella Di Muzio, N.; Fiorino, C.; Cozzarini, C.. - In: RADIOTHERAPY AND ONCOLOGY. - ISSN 0167-8140. - 192:(2024). [10.1016/j.radonc.2024.110088]
Worsening of 2-year patient-reported intestinal functionality after radiotherapy for prostate cancer including pelvic node irradiation
Moretti E.;Gatti M.;Gisella Di Muzio N.;
2024-01-01
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 midpoint 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 Delta 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 2year absolute scores. The Delta Acute largely modulated 2 -year worsening: patients with Delta Acute greater than the first quartile (Q1) and Delta 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 Delta Acute <= Q1 vs Delta 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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
