Acute and late complications after radiotherapy for prostate cancer: Results of a multicenter randomized trial comparing 68 Gy to 78 Gy

Peeters, Stéphanie; Heemsbergen, Wilma D.; Putten, Wim L.J. van; Slot, Annerie; Tabak, Hans; Mens, Jan Willem M.; Lebesque, Joos V.; Koper, P.

doi:10.1016/j.ijrobp.2004.07.715

Cited by 394 publications

(230 citation statements)

References 48 publications

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“…Baseline symptoms were found to offer the strongest predictive value for incontinence and frequency across all time points and peak incidence, consistent with previous reports [11,12]. However, as seen via analysis of urinary symptoms in isolation, the effect of baseline is not uniformly strong across all symptom types.…”

Section: Discussionsupporting

confidence: 88%

“…Observations by Peeters et al [11] of increasing late urinary symptoms in patients who smoke was dismissed as a random discovery, however, the current study made a similar finding suggesting that the relationship is potentially relevant. The impact of smoking has previously been found for rectal toxicity associated with amplified vascular damage, tissue hypoxia and fibrosis [37].…”

Section: Discussionsupporting

confidence: 47%

“…Combination of different symptoms into grades (e.g. RTOG scale as in [3,9,11,12]) has the potential to obscure relevant associations if individual symptoms have different pathophysiological origins, thus, symptoms were atomised. We indeed found several factors which were influencing a specific urinary symptom and not others, facilitating a more symptom-specific pathophysiological understanding.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment-related radiotherapy injury is complex where the process of healing undergoes a series of events that are yet to be fully comprehended [36]. Conventionally, toxicity studies separate the events into two phases, acute and late, of which acute symptoms are defined as symptoms happening in the first 3 months after the end of treatment while late symptoms are defined as all symptoms occurring after that [11,34]. It has been shown that the two phases do not share a similar set of predictors suggesting potentially different pathophysiological processes [11,34].…”

Section: Discussionmentioning

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%

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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

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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

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

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Hypofractionation for clinically localized prostate cancer

Hickey

James

Daly

et al. 2019

Cochrane Database of Systematic Reviews

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Background Using hypofractionation (fewer, larger doses of daily radiation) to treat localized prostate cancer may improve convenience and resource use. For hypofractionation to be feasible, it must be at least as effective for cancer-related outcomes and have comparable toxicity and quality of life outcomes as conventionally fractionated radiation therapy. Objectives To assess the effects of hypofractionated external beam radiation therapy compared to conventionally fractionated external beam radiation therapy for men with clinically localized prostate cancer. Search methods We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid) and trials registries from 1946 to 15 March 2019 with reference checking, citation searching and contact with study authors. Searches were not limited by language or publication status. We reran all searches within three months (15th March 2019) prior to publication. Selection criteria Randomized controlled comparisons which included men with clinically localized prostate adenocarcinoma where hypofractionated radiation therapy (external beam radiation therapy) to the prostate using hypofractionation (greater than 2 Gy per fraction) compared with conventionally fractionated radiation therapy to the prostate delivered using standard fractionation (1.8 Gy to 2 Gy per fraction). Data collection and analysis We used standard Cochrane methodology. Two authors independently assessed trial quality and extracted data. We used Review Manager 5 for data analysis and meta-analysis. We used the inverse variance method and random-effects model for data synthesis of time-to-event data with hazard ratios (HR) and 95% confidence intervals (CI) reported. For dichotomous data, we used the Mantel-Haenzel method and random-effects model to present risk ratios (RR) and 95% CI. We used GRADE to assess evidence quality for each outcome. Main results We included 10 studies with 8278 men in our analysis comparing hypofractionation with conventional fractionation to treat prostate cancer. Primary outcomes Hypofractionation for clinically localized prostate cancer (Review)

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Dose-escalated radiotherapy for clinically localized and locally advanced prostate cancer

Kim

Kong

Lee

et al. 2023

Cochrane Database of Systematic Reviews

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Acute and late complications after radiotherapy for prostate cancer: Results of a multicenter randomized trial comparing 68 Gy to 78 Gy

Cited by 394 publications

References 48 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

Hypofractionation for clinically localized prostate cancer

Dose-escalated radiotherapy for clinically localized and locally advanced prostate cancer

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