Nomograms to predict late urinary toxicity after prostate cancer radiotherapy View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-08-29

AUTHORS

Romain Mathieu, Juan David Ospina Arango, Véronique Beckendorf, Jean-Bernard Delobel, Taha Messai, Ciprian Chira, Alberto Bossi, Elisabeth Le Prisé, Stéphane Guerif, Jean-Marc Simon, Bernard Dubray, Jian Zhu, Jean-Léon Lagrange, Pascal Pommier, Khemara Gnep, Oscar Acosta, Renaud De Crevoisier

ABSTRACT

ObjectiveTo analyze late urinary toxicity after prostate cancer radiotherapy (RT): symptom description and identification of patient characteristics or treatment parameters allowing for the generation of nomograms.MethodsNine hundred and sixty-five patients underwent RT in seventeen French centers for localized prostate cancer. Median total dose was 70 Gy (range, 65–80 Gy), using different fractionations (2 or 2.5 Gy/day) and techniques. Late urinary toxicity and the corresponding symptoms (urinary frequency, incontinence, dysuria/decreased stream, and hematuria) were prospectively assessed in half of the patients using the LENT-SOMA classification. Univariate and multivariate Cox regression models addressed patient or treatment-related predictors of late urinary toxicity (≥grade 2). Nomograms were built up, and their performance was assessed.ResultsThe median follow-up was 61 months. The 5-year (≥grade 2) global urinary toxicity, urinary frequency, hematuria, dysuria, and urinary incontinence rates were 15, 10, 5, 3 and 1 %, respectively. The 5-year (≥grade 3) urinary toxicity rate was 3 %. The following parameters significantly increased the 5-year risk of global urinary toxicity (≥grade 2): anticoagulant treatment (RR = 2.35), total dose (RR = 1.09), and age (RR = 1.06). Urinary frequency was increased by the total dose (RR = 1.07) and diabetes (RR = 4). Hematuria was increased by anticoagulant treatment (RR = 2.9). Dysuria was increased by the total dose (RR = 1.1). Corresponding nomograms and their calibration plots were generated. Nomogram performance should be validated with external data. Conclusions The first nomograms to predict late urinary toxicity but also specific urinary symptoms after prostate RT were generated, contributing to prostate cancer treatment decision. More... »

PAGES

743-751

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-013-1146-8

DOI

http://dx.doi.org/10.1007/s00345-013-1146-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032079093

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23990073


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    "description": "ObjectiveTo analyze late urinary toxicity after prostate cancer radiotherapy (RT): symptom description and identification of patient characteristics or treatment parameters allowing for the generation of nomograms.MethodsNine hundred and sixty-five patients underwent RT in seventeen French centers for localized prostate cancer. Median total dose was 70\u00a0Gy (range, 65\u201380\u00a0Gy), using different fractionations (2 or 2.5\u00a0Gy/day) and techniques. Late urinary toxicity and the corresponding symptoms (urinary frequency, incontinence, dysuria/decreased stream, and hematuria) were prospectively assessed in half of the patients using the LENT-SOMA classification. Univariate and multivariate Cox regression models addressed patient or treatment-related predictors of late urinary toxicity (\u2265grade 2). Nomograms were built up, and their performance was assessed.ResultsThe median follow-up was 61\u00a0months. The 5-year (\u2265grade 2) global urinary toxicity, urinary frequency, hematuria, dysuria, and urinary incontinence rates were 15, 10, 5, 3 and 1\u00a0%, respectively. The 5-year (\u2265grade 3) urinary toxicity rate was 3\u00a0%. The following parameters significantly increased the 5-year risk of global urinary toxicity (\u2265grade 2): anticoagulant treatment (RR\u00a0=\u00a02.35), total dose (RR\u00a0=\u00a01.09), and age (RR\u00a0=\u00a01.06). Urinary frequency was increased by the total dose (RR\u00a0=\u00a01.07) and diabetes (RR\u00a0=\u00a04). Hematuria was increased by anticoagulant treatment (RR\u00a0=\u00a02.9). Dysuria was increased by the total dose (RR\u00a0=\u00a01.1). Corresponding nomograms and their calibration plots were generated. Nomogram performance should be validated with external data.\nConclusions\nThe first nomograms to predict late urinary toxicity but also specific urinary symptoms after prostate RT were generated, contributing to prostate cancer treatment decision.", 
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22 schema:description ObjectiveTo analyze late urinary toxicity after prostate cancer radiotherapy (RT): symptom description and identification of patient characteristics or treatment parameters allowing for the generation of nomograms.MethodsNine hundred and sixty-five patients underwent RT in seventeen French centers for localized prostate cancer. Median total dose was 70 Gy (range, 65–80 Gy), using different fractionations (2 or 2.5 Gy/day) and techniques. Late urinary toxicity and the corresponding symptoms (urinary frequency, incontinence, dysuria/decreased stream, and hematuria) were prospectively assessed in half of the patients using the LENT-SOMA classification. Univariate and multivariate Cox regression models addressed patient or treatment-related predictors of late urinary toxicity (≥grade 2). Nomograms were built up, and their performance was assessed.ResultsThe median follow-up was 61 months. The 5-year (≥grade 2) global urinary toxicity, urinary frequency, hematuria, dysuria, and urinary incontinence rates were 15, 10, 5, 3 and 1 %, respectively. The 5-year (≥grade 3) urinary toxicity rate was 3 %. The following parameters significantly increased the 5-year risk of global urinary toxicity (≥grade 2): anticoagulant treatment (RR = 2.35), total dose (RR = 1.09), and age (RR = 1.06). Urinary frequency was increased by the total dose (RR = 1.07) and diabetes (RR = 4). Hematuria was increased by anticoagulant treatment (RR = 2.9). Dysuria was increased by the total dose (RR = 1.1). Corresponding nomograms and their calibration plots were generated. Nomogram performance should be validated with external data. Conclusions The first nomograms to predict late urinary toxicity but also specific urinary symptoms after prostate RT were generated, contributing to prostate cancer treatment decision.
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29 schema:keywords Cox regression model
30 French centers
31 LENT-SOMA classification
32 MethodsNine hundred
33 Nomogram performance
34 ObjectiveTo
35 age
36 anticoagulant treatment
37 calibration plots
38 cancer
39 cancer radiotherapy
40 cancer treatment decisions
41 center
42 characteristics
43 classification
44 conclusion
45 corresponding symptoms
46 data
47 decisions
48 description
49 diabetes
50 different fractionations
51 dose
52 dysuria
53 external data
54 first nomogram
55 fractionation
56 frequency
57 generation
58 generation of nomograms
59 global urinary toxicity
60 half
61 hematuria
62 hundreds
63 identification
64 incontinence rates
65 late urinary toxicity
66 median total dose
67 model
68 months
69 nomogram
70 parameters
71 patient characteristics
72 patients
73 performance
74 plots
75 predictors
76 prostate cancer
77 prostate cancer radiotherapy
78 prostate radiotherapy
79 radiotherapy
80 rate
81 regression models
82 risk
83 specific urinary symptoms
84 symptom descriptions
85 symptoms
86 technique
87 total dose
88 toxicity
89 toxicity rates
90 treatment
91 treatment decisions
92 treatment parameters
93 treatment-related predictors
94 urinary frequency
95 urinary incontinence rate
96 urinary symptoms
97 urinary toxicity
98 urinary toxicity rate
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