AI Article Synopsis
- The study analyzes clinical toxicity and patient-reported outcomes in prostate cancer patients treated with proton beam therapy (PBT), focusing on the largest cohort using pencil beam scanning PBT.
- A total of 192 patients were followed for over a year, revealing low-grade 3 toxicity in 5 patients and no severe toxicity; quality of life showed stable urinary function but slight decline in sexual health.
- Younger age was linked to less sexual toxicity, while bowel issues mainly involved transient rectal bleeding, particularly in those on anticoagulation therapy.
Article Abstract
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.
Trial Registration: NCT, NCT01255748 . Registered 1 January 2013.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142310 | PMC |
| http://dx.doi.org/10.1186/s13014-018-1127-6 | DOI Listing |
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