Multinational Prospective Study of Patient-Reported Outcomes After Prostate Radiation Therapy : Detailed Assessment of Rectal Bleeding

Copyright © 2016 Elsevier Inc. All rights reserved..

PURPOSE: The new short Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) patient-reported health-related quality of life (HRQOL) tool has removed the rectal bleeding question from the previous much longer version, EPIC-26. Herein, we assess the impact of losing the dedicated rectal bleeding question in 2 independent prospective multicenter cohorts.

METHODS AND MATERIALS: In a prospective multicenter test cohort (n=865), EPIC-26 patient-reported HRQOL data were collected for 2 years after treatment from patients treated with prostate radiation therapy from 2003 to 2011. A second prospective multicenter cohort (n=442) was used for independent validation. A repeated-effects model was used to predict the change from baseline in bowel summary scores from longer EPIC instruments using the change in EPIC-CP bowel summary scores with and without rectal bleeding scores.

RESULTS: Two years after radiation therapy, 91% of patients were free of bleeding, and only 2.6% reported bothersome bleeding problems. Correlations between EPIC-26 and EPIC-CP bowel scores were very high (r2=0.90-0.96) and were statistically improved with the addition of rectal bleeding information (r2=0.94-0.98). Considering all patients, only 0.2% of patients in the test cohort and 0.7% in the validation cohort reported bothersome bleeding and had clinically relevant HRQOL changes missed with EPIC-CP. However, of the 2.6% (n=17) of men with bothersome rectal bleeding in the test cohort, EPIC-CP failed to capture 1 patient (6%) as experiencing meaningful declines in bowel HRQOL.

CONCLUSIONS: Modern prostate radiation therapy results in exceptionally low rates of bothersome rectal bleeding, and <1% of patients experience bothersome bleeding and are not captured by EPIC-CP as having meaningful HRQOL declines after radiation therapy. However, in the small subset of patients with bothersome rectal bleeding, the longer EPIC-26 should strongly be considered, given its superior performance in this patient subset.

Medienart:

E-Artikel

Erscheinungsjahr:

2016

Erschienen:

2016

Enthalten in:

Zur Gesamtaufnahme - volume:96

Enthalten in:

International journal of radiation oncology, biology, physics - 96(2016), 4 vom: 15. Nov., Seite 770-777

Sprache:

Englisch

Beteiligte Personen:

Lee, Jae Y [VerfasserIn]
Daignault-Newton, Stephanie [VerfasserIn]
Heath, Gerard [VerfasserIn]
Scarlett, Sarah [VerfasserIn]
Sanda, Martin G [VerfasserIn]
Chang, Peter [VerfasserIn]
Regan, Meredith M [VerfasserIn]
Michalski, Jeff M [VerfasserIn]
Sandler, Howard M [VerfasserIn]
Feng, Felix Y [VerfasserIn]
Kuban, Deborah A [VerfasserIn]
Zietman, Anthony L [VerfasserIn]
Ciezki, Jay P [VerfasserIn]
Kaplan, Irving D [VerfasserIn]
Crociani, Catrina [VerfasserIn]
McLaughlin, William P [VerfasserIn]
Mantz, Constantine A [VerfasserIn]
Finkelstein, Steven E [VerfasserIn]
Suy, Simeng [VerfasserIn]
Collins, Sean P [VerfasserIn]
Garin, Olatz [VerfasserIn]
Ferrer, Montserrat [VerfasserIn]
Hamstra, Daniel A [VerfasserIn]
Spratt, Daniel E [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Multicenter Study
Validation Study

Anmerkungen:

Date Completed 10.07.2017

Date Revised 10.12.2019

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ijrobp.2016.07.038

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM264651596