Comparison of Physician-recorded Toxicities and Patient-reported Outcomes of Five Different Radiotherapy Methods for Prostate Cancer

Ito, Makoto; Sasamura, Kazuma; Takase, Yuuki; Kotsuma, Tadayuki; Oshima, Yukihiko; Minami, Yoshitaka; Suzuki, Junji; Tanaka, Eiichi; Ohashi, Wataru; Oguchi, Masahiko; Okuda, Takayoshi; Suzuki, Kôjiro; Yoshioka, Yasuo

doi:10.21873/anticanres.15030

Cited by 8 publications

(6 citation statements)

References 14 publications

(19 reference statements)

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“…Many patients with prostate cancer are candidates for definitive or adjuvant radiotherapy. The anticipation of radiation treatment may lead to sleep disturbances as a consequence of distress and fear regarding the unknown modern technology, exposure to radiation, and treatmentassociated toxicity (2)(3)(4)(5)(6).…”

Section: Discussionmentioning

confidence: 99%

Frequency and Risk Factors of Sleep Disturbances in Patients With Prostate Cancer Assigned to Local or Loco-regional Radiotherapy

et al. 2021

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Background/Aim: Many patients with prostate cancer receive definitive or adjuvant radiotherapy. This study aimed to identify the frequency of sleep disturbances and corresponding risk factors prior to radiation treatment. Patients and Methods: Data of 48 patients assigned to local or loco-regional irradiation for prostate cancer were retrospectively analyzed for pre-radiotherapy sleep disturbances. Fifteen characteristics were analyzed including age, performance status, comorbidity, history of previous malignancy, distress score, (emotional, physical or practical) problems, prostate-specific antigen, primary tumor stage, Gleason-score, upfront androgen deprivation therapy (ADT), treatment volume, brachytherapy, and COVID-19 pandemic. Results: Pre-radiotherapy sleep disturbances were reported by 20.8% of patients and significantly associated with distress scores ≥4 (p<0.0001) and ≥3 physical problems (p=0.0001). Trends were found for Karnofsky performance score ≤80 (p=0.095), Gleason score 7b-9 (p=0.079), and ADT (p=0.067). Conclusion: Pre-radiotherapy sleep disturbances were less common in prostate cancer patients than in other cancer patients. Risk factors were identified that can help identify patients requiring psychological support prior to radiotherapy.Prostate cancer represents the most common malignancy in men (1). Many patients with prostate cancer are treated with local or loco-regional irradiation, either with external beam radiotherapy (EBRT) alone, EBRT plus brachytherapy or brachytherapy alone. To be assigned only to radiation treatment may cause significant emotional distress including fear about the unknown technology, exposure to radiation, and possible side effects of the planned treatment (2-6). Emotional distress may lead to burdensome sleep disturbances.In the study of Thomas et al. that included 23 patients (41%) irradiated for prostate cancer, patients reported sleep disturbances mostly prior to and during early weeks of radiotherapy (7). Moreover, in the prospective study of Holliday et al. that investigated 28 men irradiated for earlystage prostate cancer, sleep efficiency improved and sleeponset latency decreased during the course of treatment (8).However, only very limited data are available regarding sleep disturbances in patients just before receiving local or loco-regional radiotherapy for prostate cancer. Therefore, we performed this study, mainly to provide data regarding the frequency and potential risk factors of pre-radiotherapy sleep disturbances in this group of patients. Knowledge of risk factors can help identify patients who would benefit from psychological support already before the beginning of their radiotherapy course. Patients and MethodsData of 48 patients receiving local or loco-regional irradiation for prostate cancer, who completed a National Comprehensive Cancer Network Distress Thermometer evaluation prior to the start of treatment (9, 10) were retrospectively analyzed for sleep disturbances. The study was approved by the responsible Ethics Committee (University o...

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Section: Discussionmentioning

confidence: 99%

Frequency and Risk Factors of Sleep Disturbances in Patients With Prostate Cancer Assigned to Local or Loco-regional Radiotherapy

et al. 2021

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“…In case of high risk or lymph node positive disease, radiotherapy often includes the elective pelvic lymph nodes. Prostate radiotherapy can be associated with significant acute and late toxicities and emotional distress (3)(4)(5)(6). It is clinically relevant to identify patients who are at risk of experiencing emotional distress prior to or during prostate radiotherapy.…”

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confidence: 99%

Prevalence and Risk Factors of Emotional Distress in Patients With Prostate Cancer Assigned to External-beam Radiotherapy With or Without High-dose Rate Brachytherapy

2023

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Background/Aim: Upcoming radiotherapy for prostate cancer may lead to emotional distress. This study aimed to identify the prevalence and risk factors in a retrospective cohort of 102 patients. Patients and Methods: Thirteen characteristics were evaluated for six emotional problems. To account for multiple comparisons, Bonferroni correction was used; p-values <0.0038 were significant (alpha level <0.05). Results: Prevalence of worry, fears, sadness, depression, nervousness, and loss of interest in usual activities was 25%, 27%, 11%, 11%, 18%, and 5%, respectively. A greater number of physical problems was significantly associated with worry (p=0.0037) and fears (p<0.0001) and showed trends regarding sadness (p=0.011) and depression (p=0.011). Trends were also found for associations between younger age and worry (p=0.021), advanced primary tumor stage and fears (p=0.025), patient's history of another malignancy and nervousness (p=0.035), and between external-beam radiotherapy alone and fears (p=0.042) or nervousness (p=0.037). Conclusion: Although the prevalence of emotional distress was comparably low, patients with risk factors may benefit from early psychological support.

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“…The cumulative incidence of late GU grade≥2 toxicities was the highest with UHRT and significantly higher with UHRT than with HDR-BT (p=0.005). Higher symptom score peaks were noted 4 weeks after therapy with LDR-BT than those after external beam radiation therapy (34).…”

Section: Discussionmentioning

confidence: 85%

Lower Bladder Toxicity of SalvageVersusAdjuvant Modern Radiotherapy for Prostate Cancer Patients

Vinciguerra¹,

Augurio²,

Rosa³

et al. 2022

In Vivo

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Background/Aim: In prostate cancer, postoperative radiotherapy timing is debated to avoid overtreatments and toxicities. This study compared acute and late rectal and bladder toxicities in the adjuvant and salvage setting. Patients and Methods: In total, 129 patients were analyzed in two groups: adjuvant radiotherapy (aRT) and salvage radiotherapy (sRT). Results: In aRT and sRT, grade 1 (G1) acute bladder toxicities were detected in 40 and 30 patients, and grade 2 (G2) in 1 and 6; G1 late bladder toxicities were described in 30 and 20, and G2 in 6 and 2, respectively. In aRT and sRT, acute G1 rectal toxicities were reported in 18 and 27 patients, and G2 in 5 and 4, respectively. Late rectal G1 toxicities were observed in 10 patients, G2 in 6 and G3 in 1 in the aRT. In sRT, 8 patients and 1 developed G1 and G2 toxicities, respectively. Regarding bladder toxicity, a higher incidence occurred in aRT; late toxicity was lower in sRT. Conclusion: Adjuvant and salvage RT in prostate cancer treatment resulted in acceptable toxicities.The role of adjuvant radiotherapy (aRT) after radical prostatectomy has been previously demonstrated in three randomized trials (1-6) prescribing aRT in cases of seminal vesicles invasion (SVI), positive surgical margins (PSM) or extracapsular extension (ECE). aRT has demonstrated to obtain reductions in biochemical recurrence, local recurrence, and clinical progression (7, 8).Postoperative salvage radiotherapy (sRT) should be proposed in cases of biochemical [prostate specific antigen (PSA) levels of 0.2 ng/ml or higher] or local recurrence. A low pretreatment serum PSA level was the most important factor of sRT response (9-11).However, the role and timing of postoperative treatment still remains a current, debated and interesting argument, with the possibility of treatment recommendation only in recurrences, in order to avoid overtreatment. Furthermore, RT delay could reduce treatment-related toxicity, improving quality of life (12, 13). In fact, urinary incontinence and urethral stricture formation, that could occur after radical prostatectomy, could be intensified with radiotherapy (14).Furthermore, highly conformal radiotherapy techniques, such as intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and image guided radiotherapy (IGRT), in contrast to standard 3D-CRT, in both adjuvant and salvage settings, could reduce gastrointestinal and genitourinary adverse events (15-17).Three randomized trials compared adjuvant and salvage treatment and suggested early salvage RT as the preferable option for avoiding overtreatment and possible side-effects, whereas aRT does not improve PSA-free survival (18-20). Also, the prospectively planned systematic review and meta-analysis of the ARTISTIC collaboration confirmed these results. This meta-analysis included 2,153 patients of the RADICALS, GETUG-AFU 17, and RAVES trials, in order to assess aRT effects versus those of sRT (21). The proportion of patients free of biochemical progression at 5 years was high, approxima...

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Comparison of Physician-recorded Toxicities and Patient-reported Outcomes of Five Different Radiotherapy Methods for Prostate Cancer

Cited by 8 publications

References 14 publications

Frequency and Risk Factors of Sleep Disturbances in Patients With Prostate Cancer Assigned to Local or Loco-regional Radiotherapy

Frequency and Risk Factors of Sleep Disturbances in Patients With Prostate Cancer Assigned to Local or Loco-regional Radiotherapy

Prevalence and Risk Factors of Emotional Distress in Patients With Prostate Cancer Assigned to External-beam Radiotherapy With or Without High-dose Rate Brachytherapy

Lower Bladder Toxicity of SalvageVersusAdjuvant Modern Radiotherapy for Prostate Cancer Patients

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