A pooled patient‐reported outcomes analysis of moderately hypofractionated proton beam therapy and photon‐based intensity modulated radiation therapy for low‐ or intermediate‐risk prostate cancer
Background We sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer (PC). Methods This multi‐institutional analysis included low‐ or intermedi...
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Published in | The Prostate Vol. 84; no. 4; pp. 395 - 402 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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01.03.2024
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Abstract | Background
We sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer (PC).
Methods
This multi‐institutional analysis included low‐ or intermediate‐risk group PC patients treated with moderately hypofractionated radiation to an intact prostate stratified by treatment modality: IMRT or PBT. The primary outcomes were prospectively collected patient‐reported late gastrointestinal (GI) and genitourinary (GU) toxicity assessed by International Prostate Symptom Score (IPSS) and Expanded PC Index Composite (EPIC). Multivariable regression analysis (MVA) controlling for age, race, and risk group tested the effect of time, treatment, and their interaction.
Results
287 IMRT and 485 PBT patients were included. Intermediate risk group (81.2 vs. 68.2%; p < 0.001) and median age at diagnosis (70 vs. 67 years; p < 0.001) were higher in the IMRT group. On MVA, there was no significant difference between modalities. PBT IPSS did not differ from IMRT IPSS at 12 months (odds ratio [OR], 1.19; p = 0.08) or 24 months (OR, 0.99; p = 0.94). PBT EPIC overall GI function at 12 months (OR, 3.68; p = 0.085) and 24 months (OR 2.78; p = 0.26) did not differ from IMRT EPIC overall GI function. At 24 months, urinary frequency was no different between PBT and IMRT groups (OR 0.35; p = 0.096).
Conclusions
This multi‐institutional analysis of low‐ or intermediate‐risk PC treated with moderately hypofractionated PBT and IMRT demonstrated low rates of late patient‐reported GI and GU toxicities. After covariate adjustment, late GI and GU PROs were not significantly different between PBT or IMRT cohorts. |
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AbstractList | Background
We sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer (PC).
Methods
This multi‐institutional analysis included low‐ or intermediate‐risk group PC patients treated with moderately hypofractionated radiation to an intact prostate stratified by treatment modality: IMRT or PBT. The primary outcomes were prospectively collected patient‐reported late gastrointestinal (GI) and genitourinary (GU) toxicity assessed by International Prostate Symptom Score (IPSS) and Expanded PC Index Composite (EPIC). Multivariable regression analysis (MVA) controlling for age, race, and risk group tested the effect of time, treatment, and their interaction.
Results
287 IMRT and 485 PBT patients were included. Intermediate risk group (81.2 vs. 68.2%; p < 0.001) and median age at diagnosis (70 vs. 67 years; p < 0.001) were higher in the IMRT group. On MVA, there was no significant difference between modalities. PBT IPSS did not differ from IMRT IPSS at 12 months (odds ratio [OR], 1.19; p = 0.08) or 24 months (OR, 0.99; p = 0.94). PBT EPIC overall GI function at 12 months (OR, 3.68; p = 0.085) and 24 months (OR 2.78; p = 0.26) did not differ from IMRT EPIC overall GI function. At 24 months, urinary frequency was no different between PBT and IMRT groups (OR 0.35; p = 0.096).
Conclusions
This multi‐institutional analysis of low‐ or intermediate‐risk PC treated with moderately hypofractionated PBT and IMRT demonstrated low rates of late patient‐reported GI and GU toxicities. After covariate adjustment, late GI and GU PROs were not significantly different between PBT or IMRT cohorts. Abstract Background We sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer (PC). Methods This multi‐institutional analysis included low‐ or intermediate‐risk group PC patients treated with moderately hypofractionated radiation to an intact prostate stratified by treatment modality: IMRT or PBT. The primary outcomes were prospectively collected patient‐reported late gastrointestinal (GI) and genitourinary (GU) toxicity assessed by International Prostate Symptom Score (IPSS) and Expanded PC Index Composite (EPIC). Multivariable regression analysis (MVA) controlling for age, race, and risk group tested the effect of time, treatment, and their interaction. Results 287 IMRT and 485 PBT patients were included. Intermediate risk group (81.2 vs. 68.2%; p < 0.001) and median age at diagnosis (70 vs. 67 years; p < 0.001) were higher in the IMRT group. On MVA, there was no significant difference between modalities. PBT IPSS did not differ from IMRT IPSS at 12 months (odds ratio [OR], 1.19; p = 0.08) or 24 months (OR, 0.99; p = 0.94). PBT EPIC overall GI function at 12 months (OR, 3.68; p = 0.085) and 24 months (OR 2.78; p = 0.26) did not differ from IMRT EPIC overall GI function. At 24 months, urinary frequency was no different between PBT and IMRT groups (OR 0.35; p = 0.096). Conclusions This multi‐institutional analysis of low‐ or intermediate‐risk PC treated with moderately hypofractionated PBT and IMRT demonstrated low rates of late patient‐reported GI and GU toxicities. After covariate adjustment, late GI and GU PROs were not significantly different between PBT or IMRT cohorts. BackgroundWe sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer (PC).MethodsThis multi‐institutional analysis included low‐ or intermediate‐risk group PC patients treated with moderately hypofractionated radiation to an intact prostate stratified by treatment modality: IMRT or PBT. The primary outcomes were prospectively collected patient‐reported late gastrointestinal (GI) and genitourinary (GU) toxicity assessed by International Prostate Symptom Score (IPSS) and Expanded PC Index Composite (EPIC). Multivariable regression analysis (MVA) controlling for age, race, and risk group tested the effect of time, treatment, and their interaction.Results287 IMRT and 485 PBT patients were included. Intermediate risk group (81.2 vs. 68.2%; p < 0.001) and median age at diagnosis (70 vs. 67 years; p < 0.001) were higher in the IMRT group. On MVA, there was no significant difference between modalities. PBT IPSS did not differ from IMRT IPSS at 12 months (odds ratio [OR], 1.19; p = 0.08) or 24 months (OR, 0.99; p = 0.94). PBT EPIC overall GI function at 12 months (OR, 3.68; p = 0.085) and 24 months (OR 2.78; p = 0.26) did not differ from IMRT EPIC overall GI function. At 24 months, urinary frequency was no different between PBT and IMRT groups (OR 0.35; p = 0.096).ConclusionsThis multi‐institutional analysis of low‐ or intermediate‐risk PC treated with moderately hypofractionated PBT and IMRT demonstrated low rates of late patient‐reported GI and GU toxicities. After covariate adjustment, late GI and GU PROs were not significantly different between PBT or IMRT cohorts. We sought to characterize and compare late patient-reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer (PC). This multi-institutional analysis included low- or intermediate-risk group PC patients treated with moderately hypofractionated radiation to an intact prostate stratified by treatment modality: IMRT or PBT. The primary outcomes were prospectively collected patient-reported late gastrointestinal (GI) and genitourinary (GU) toxicity assessed by International Prostate Symptom Score (IPSS) and Expanded PC Index Composite (EPIC). Multivariable regression analysis (MVA) controlling for age, race, and risk group tested the effect of time, treatment, and their interaction. 287 IMRT and 485 PBT patients were included. Intermediate risk group (81.2 vs. 68.2%; p < 0.001) and median age at diagnosis (70 vs. 67 years; p < 0.001) were higher in the IMRT group. On MVA, there was no significant difference between modalities. PBT IPSS did not differ from IMRT IPSS at 12 months (odds ratio [OR], 1.19; p = 0.08) or 24 months (OR, 0.99; p = 0.94). PBT EPIC overall GI function at 12 months (OR, 3.68; p = 0.085) and 24 months (OR 2.78; p = 0.26) did not differ from IMRT EPIC overall GI function. At 24 months, urinary frequency was no different between PBT and IMRT groups (OR 0.35; p = 0.096). This multi-institutional analysis of low- or intermediate-risk PC treated with moderately hypofractionated PBT and IMRT demonstrated low rates of late patient-reported GI and GU toxicities. After covariate adjustment, late GI and GU PROs were not significantly different between PBT or IMRT cohorts. |
Author | Vapiwala, Neha Davis, Brian J. Hallman, Mark Mendenhall, Nancy P. Henderson, Randal H. Horwitz, Eric M. Stish, Bradley J. Handorf, Elizabeth Wong, Jessica Karen Lukez, Alexander |
Author_xml | – sequence: 1 givenname: Alexander orcidid: 0000-0002-0520-1077 surname: Lukez fullname: Lukez, Alexander organization: Fox Chase Cancer Center – sequence: 2 givenname: Elizabeth surname: Handorf fullname: Handorf, Elizabeth organization: Fox Chase Cancer Center – sequence: 3 givenname: Nancy P. surname: Mendenhall fullname: Mendenhall, Nancy P. organization: University of Florida – sequence: 4 givenname: Randal H. surname: Henderson fullname: Henderson, Randal H. organization: UF Health Proton Therapy Institute – sequence: 5 givenname: Bradley J. surname: Stish fullname: Stish, Bradley J. organization: Mayo Clinic – sequence: 6 givenname: Brian J. surname: Davis fullname: Davis, Brian J. organization: Mayo Clinic – sequence: 7 givenname: Mark surname: Hallman fullname: Hallman, Mark organization: Fox Chase Cancer Center – sequence: 8 givenname: Eric M. surname: Horwitz fullname: Horwitz, Eric M. organization: Fox Chase Cancer Center – sequence: 9 givenname: Neha surname: Vapiwala fullname: Vapiwala, Neha organization: University of Pennsylvania – sequence: 10 givenname: Jessica Karen orcidid: 0000-0002-4331-9164 surname: Wong fullname: Wong, Jessica Karen email: jessica.wong@fccc.edu organization: Fox Chase Cancer Center |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38108113$$D View this record in MEDLINE/PubMed |
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We sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy... We sought to characterize and compare late patient-reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and... Abstract Background We sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation... BackgroundWe sought to characterize and compare late patient‐reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy... BACKGROUNDWe sought to characterize and compare late patient-reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy... |
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StartPage | 395 |
SubjectTerms | Humans hypofractionation Male Patient Reported Outcome Measures patient reported outcomes Prostate - radiation effects Prostate cancer Prostatic Neoplasms - radiotherapy proton therapy Proton Therapy - adverse effects quality of life Radiation therapy Radiotherapy, Intensity-Modulated - adverse effects Toxicity |
Title | A pooled patient‐reported outcomes analysis of moderately hypofractionated proton beam therapy and photon‐based intensity modulated radiation therapy for low‐ or intermediate‐risk prostate cancer |
URI | https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fpros.24660 https://www.ncbi.nlm.nih.gov/pubmed/38108113 https://www.proquest.com/docview/2917777554 https://search.proquest.com/docview/2903324400 |
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