Comprehensive geriatric assessment predicts radiation-induced acute toxicity in prostate cancer patients

Abstract

Purpose The purpose of the present prospective study was to evaluate the significance of geriatric conditions measured by a comprehensive geriatric assessment (GA) for the prediction of the risk of high-grade acute radiation-induced toxicity. Methods A total of 314 prostate cancer patients (age ≥ 65 years) undergoing definitive radiotherapy at a tertiary academic center were included. Prior to treatment, patients underwent a GA. High-grade toxicity was defined as acute toxicity grade ≥ 2 according to standard RTOG/EORTC criteria. To analyze the predictive value of the GA, univariable and multivariable logistic regression models were applied. Results A total of 40 patients (12.7%) developed acute toxicity grade ≥ 2; high grade genitourinary was found in 37 patients (11.8%) and rectal toxicity in 8 patients (2.5%), respectively. Multivariable analysis revealed a significant association of comorbidities with overall toxicity grade ≥ 2 (odds ratio [OR] 2.633, 95% confidence interval [CI] 1.260–5.502; p = 0.010) as well as with high-grade genitourinary and rectal toxicity (OR 2.169, 95%CI1.017–4.625; p = 0.045 and OR 7.220, 95%CI 1.227–42.473; p = 0.029, respectively). Furthermore, the Activities of Daily Living score (OR 0.054, 95%CI 0.004–0.651; p = 0.022), social status (OR 0.159, 95%CI 0.028–0.891; p = 0.036), and polypharmacy (OR 4.618, 95%CI 1.045–20.405; p = 0.044) were identified as independent predictors of rectal toxicity grade ≥ 2. Conclusion Geriatric conditions seem to be predictive of the development of high-grade radiation-induced toxicity in prostate cancer patients treated with definitive radiotherapy.

Retrospective study on the toxicity induced by stereotactic body radiotherapy: overview of the reunion experience on prostate cancer in elderly patients

“…Importantly, geriatric conditions may affect response to radiation and studies reported that comprehensive geriatric assessment (CGA) can help to predict the occurrence of acute radiation-induced toxicities for patients treated for PCa or Head and neck cancers ( 30 – 32 ).…”