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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30 French centers
31 MethodsNine hundred
32 Nomogram performance
33 ObjectiveTo
34 age
35 anticoagulant treatment
36 calibration plots
37 cancer
38 cancer radiotherapy
39 cancer treatment decisions
40 center
41 characteristics
42 classification
43 conclusion
44 corresponding symptoms
45 data
46 decisions
47 description
48 diabetes
49 different fractionations
50 dose
51 dysuria
52 external data
53 first nomogram
54 fractionation
55 frequency
56 generation
57 half
58 hematuria
59 hundreds
60 identification
61 incontinence rates
62 late urinary toxicity
63 median total dose
64 model
65 months
66 nomogram
67 parameters
68 patient characteristics
69 patients
70 performance
71 plots
72 predictors
73 prostate cancer
74 prostate cancer radiotherapy
75 prostate radiotherapy
76 radiotherapy
77 rate
78 regression models
79 risk
80 specific urinary symptoms
81 symptom descriptions
82 symptoms
83 technique
84 total dose
85 toxicity
86 toxicity rates
87 treatment
88 treatment decisions
89 treatment parameters
90 treatment-related predictors
91 urinary frequency
92 urinary incontinence rate
93 urinary symptoms
94 urinary toxicity
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