Navigation Links
Italian study examines clinical predictors of acute urinary symptoms after radiotherapy for prostate
Date:11/15/2013

Arnhem, The Netherlands - An interim study by Italian researchers showed that using a modelling programme together with IPSS and dosage measure can predict the severity of acute urinary symptoms in patients with early prostate cancer who underwent radiotherapy.

"Quantitative models predicting the risk of acute (and late) genito-urinary (GU) toxicity in patients treated with high dose radiotherapy for prostate cancer are lacking. This work represents one of the first attempts to provide radiation oncologists with quantitative tools to reliably predict the risk of moderate-severe acute GU effects based on both clinical and dosimetric individual parameters," said Dr. Cesare Cozzarini of the San Raffaele Scientific Institute, Dept. of Radiation Oncology in Milan, Italy.

Cozzarini presented the findings at the 5th European Multidisciplinary Meeting on Urological Cancers (EMUC) held in Marseille. A prospective cohort study (DUE-01) which started in April 2010, Cozzarini and colleagues aimed to develop predictive models of genito-urinary (GU) toxicity and erectile dysfunction after high dose radiotherapy (RT) for prostate cancer.

Patients treated with conventional (1.8-2Gy/fr, CONV) or moderate hypo-fractionation (2.5-2.7Gy/fr HYPO) were included.

In their ad-interim analysis, the investigators also intended to find a link between pollakiuria (POLL), dysuria (DYS) and nicturia (NICT) as measured by IPSS at RT end and clinical/dosimetric risk factors.

IPSS questionnaire at the start and at the end of RT were prospectively collected by the researchers and planning data were recovered and analyzed with a dedicated program (Vodca, MSS GmbH, Zurich), including absolute (cc/cm2) and % bladder dose-volume/surface (DVH/DSH) parameters referred to both the whole treatment and to the weekly delivered dose (DVHw/DSHw).

In the study, relevant clinical factors were also prospectively collected including T stage, concomitant morbidities and drugs, use of hormonal therapy (HT), previous surgery, smoking, age, BMI and prostate volume. In IPSS, each item ranges from 0 to 5 with increasing score which indicates increasing toxicity severity: for each question, a score≥4 at the end of the therapy was considered as the end point.

At the time of the analysis (January 2013), 339 patients have been enrolled by nine institutes. Clinical data of 212/339 patients were available (93 CONV and 119 HYPO). Of 172/212 patients both baseline and end-RT IPSS were collected. For 179/212 patients also DVH/DSH were available. Questions POLL, DYS and NICT (respectively 2, 3 and 7) showed the larger increase of the fraction of patients with scores ≥4 between basal and end questionnaire; consequently, the analysis focused on these symptoms.

The number of patients with scores≥4 increased from 8 to 30 for POLL, from 5 to 20 for DYS and from 12 to 34 for NICT. At MVA (overall p<0.0001), the main independent predictors of acute POLL were: Smoking (OR:2.74, p=0.04) and S8.5w (OR:1.01, p=0.10); AUC=0.66. The model was confirmed also after the exclusion of patients with baseline IPSS-POLL ≥4 (AUC=0.69).

"This study (DUE01) is aimed at prospectively collecting an enormous number of patient-reported information concerning GU toxicity (and erectile dysfunction as well) before, during and at the end of radiotherapy and for a period of five years after its completion," said Cozzarini.

"The study therefore has a high probability of helping to develop highly reliable models for the prediction of acute and late GU toxicity and erectile dysfunction and their impact on quality of life," he added.

"As a consequence, the final results of this investigation should have a significant impact on the evolution of radiotherapy of prostate cancer in the next five to 10 years leading to a significant reduction of GU toxicity and sexual dysfunction deriving from a more refined "tailoring" of the radiation therapy," according to Cozzarini.


'/>"/>

Contact: Evgenia Starkova
e.starkova@uroweb.org
European Association of Urology
Source:Eurekalert

Related medicine news :

1. Flavor Your Life Shares How to Prepare an Italian Style Orecchiette Pasta with Olive Oil
2. Flavor Your Life Shares 3 Easy Recipes that Use Italian Olive Oil to Enhance Meals
3. Mesothelioma News Update: Resource4thePeople Applauds Italian Court for Sentencing Swiss Millionaire in Asbestos Scandal
4. Springer partners with the Italian Society of Gerontology and Geriatrics
5. First Narconon Cannabis Abuse Prevention Guide Takes Aim at Drug Abuse Statistics for Italian Youth
6. Springer to collaborate with the Italian Society for the Study of Eating Disorders
7. Flavor Your Life Highlights the Importance of Taste in Italian Olive Oil
8. Nationally Renowned Health Expert Debuts Book "Sex and Spaghetti Sauce: My Italian Mother’s Recipe for Getting Healthy and Getting Busy in Your 50s and Beyond"
9. Italian wolves prefer pork to venison
10. KD LUXE Jewelry and Accessories: Introducing Chic Italian Silver and Stainless Collections in Beverly Hills and Hollywood
11. Springer launches new journal with the Italian Association of Nuclear Medicine and Molecular Imaging
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... , ... June 25, 2016 , ... "With 30 hand-drawn ... specific project," said Christina Austin - CEO of Pixel Film Studios. , ProHand ... all within Final Cut Pro X . Simply select a ProHand generator and ...
(Date:6/25/2016)... Oklahoma City, Oklahoma (PRWEB) , ... June 25, ... ... to helping both athletes and non-athletes recover from injury. Recently, he has implemented ... for the Oklahoma City area —Johnson is one of the first doctors to ...
(Date:6/24/2016)... ... 2016 , ... A recent article published June 14 on E ... goes on to state that individuals are now more comfortable seeking to undergo not ... as calf and cheek reduction. The Los Angeles area medical group, Beverly Hills Physicians ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, ... at his family verbally and physically. , “When something upset him, he couldn’t control his ... it. He would throw rocks at my other children and say he was going to ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. Amanda ... orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, including ... accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)...  Collagen Matrix, Inc., ("Collagen Matrix") the driving ... collagen and mineral based medical devices for tissue ... Messer has joined the company as Vice ... growing portfolio of oral surgery, neurosurgery, orthopaedic and ... the Collagen Matrix executive team as an accomplished ...
(Date:6/24/2016)... June 24, 2016 The Academy of Managed ... recommendations that would allow biopharmaceutical companies to more ... that make formulary and coverage decisions, a move that ... new medicines. The recommendations address restrictions in ... on the drug label, a prohibition that hinders decision ...
(Date:6/24/2016)... --  Pulmatrix, Inc ., (NASDAQ: PULM ), ... today that it was added to the Russell Microcap ... set of U.S. and global equity indexes on June ... for Pulmatrix," said Chief Executive Officer Robert Clarke ... in developing drugs for crucial unmet medical needs, and ...
Breaking Medicine Technology: