TY - JOUR
T1 - Early toxicity and patient reported quality-of-life in patients receiving proton therapy for localized prostate cancer
T2 - A single institutional review of prospectively recorded outcomes 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis
AU - Lee, Howard J.
AU - MacOmber, Meghan W.
AU - Spraker, Matthew B.
AU - Bowen, Stephen R.
AU - Hippe, Daniel S.
AU - Fung, Angela
AU - Russell, Kenneth J.
AU - Laramore, George E.
AU - Rengan, Ramesh
AU - Liao, Jay
AU - Apisarnthanarax, Smith
AU - Zeng, Jing
N1 - Funding Information:
Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Washington, supported by Institute of Translational Health Science (ITHS) grant support (UL1 TR002319 from NCATS/NIH).
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/9/17
Y1 - 2018/9/17
N2 - Background: We report prospectively captured clinical toxicity and patient reported outcomes in a single institutional cohort of patients treated for prostate cancer with proton beam therapy (PBT). This is the largest reported series of patients treated mostly with pencil beam scanning PBT. Methods: We reviewed 231 patients treated on an IRB approved institutional registry from 2013 to 2016; final analysis included 192 patients with > 1-year of follow-up. Toxicity incidence was prospectively captured and scored using CTCAE v4.0. International Prostate Symptoms Score (IPSS), Sexual Health Inventory for Men (SHIM) score, and Expanded Prostate Cancer Index Composite (EPIC) bowel domain questionnaires were collected at each visit. Univariate Cox regression was used to explore associations of grade 2+ toxicity with clinical, treatment, and dosimetric variables. Results: Median follow-up was 1.7 years. Grade 3 toxicity was seen in 5/192 patients. No grade 4 or 5 toxicity was seen. Patient reported quality-of-life showed no change in urinary function post-radiation by IPSS scores. Median SHIM scores declined by 3.7 points at 1-year post-treatment without further decrease beyond year 1. On univariate analysis, only younger age (HR = 0.61, p = 0.022) was associated with decreased sexual toxicity. EPIC bowel domain scores declined from 96 at baseline (median) by an average of 5.4 points at 1-year post-treatment (95% CI: 2.5-8.2 points, p < 0.001), with no further decrease over time. Bowel toxicity was mostly in the form of transient rectal bleeding and was associated with anticoagulation use (HR = 3.45, p = 0.002). Conclusions: Grade 3 or higher toxicity was rare at 2-years after treatment with PBT for localized prostate cancer. Longer follow-up is needed to further characterize late toxicity and biochemical control.
AB - Background: We report prospectively captured clinical toxicity and patient reported outcomes in a single institutional cohort of patients treated for prostate cancer with proton beam therapy (PBT). This is the largest reported series of patients treated mostly with pencil beam scanning PBT. Methods: We reviewed 231 patients treated on an IRB approved institutional registry from 2013 to 2016; final analysis included 192 patients with > 1-year of follow-up. Toxicity incidence was prospectively captured and scored using CTCAE v4.0. International Prostate Symptoms Score (IPSS), Sexual Health Inventory for Men (SHIM) score, and Expanded Prostate Cancer Index Composite (EPIC) bowel domain questionnaires were collected at each visit. Univariate Cox regression was used to explore associations of grade 2+ toxicity with clinical, treatment, and dosimetric variables. Results: Median follow-up was 1.7 years. Grade 3 toxicity was seen in 5/192 patients. No grade 4 or 5 toxicity was seen. Patient reported quality-of-life showed no change in urinary function post-radiation by IPSS scores. Median SHIM scores declined by 3.7 points at 1-year post-treatment without further decrease beyond year 1. On univariate analysis, only younger age (HR = 0.61, p = 0.022) was associated with decreased sexual toxicity. EPIC bowel domain scores declined from 96 at baseline (median) by an average of 5.4 points at 1-year post-treatment (95% CI: 2.5-8.2 points, p < 0.001), with no further decrease over time. Bowel toxicity was mostly in the form of transient rectal bleeding and was associated with anticoagulation use (HR = 3.45, p = 0.002). Conclusions: Grade 3 or higher toxicity was rare at 2-years after treatment with PBT for localized prostate cancer. Longer follow-up is needed to further characterize late toxicity and biochemical control.
KW - Patient reported outcomes
KW - Prostate cancer
KW - Proton therapy
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85053551231&partnerID=8YFLogxK
U2 - 10.1186/s13014-018-1127-6
DO - 10.1186/s13014-018-1127-6
M3 - Article
C2 - 30223877
AN - SCOPUS:85053551231
VL - 13
JO - Radiation oncology (London, England)
JF - Radiation oncology (London, England)
SN - 1748-717X
IS - 1
M1 - 179
ER -