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 |
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Erscheinungsjahr: |
2016 |
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Erschienen: |
2016 |
Enthalten in: |
Zur Gesamtaufnahme - volume:96 |
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Enthalten in: |
International journal of radiation oncology, biology, physics - 96(2016), 4 vom: 15. Nov., Seite 770-777 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Lee, Jae Y [VerfasserIn] |
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Anmerkungen: |
Date Completed 10.07.2017 Date Revised 10.12.2019 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1016/j.ijrobp.2016.07.038 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM264651596 |
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100 | 1 | |a Lee, Jae Y |e verfasserin |4 aut | |
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500 | |a Date Revised 10.12.2019 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2016 Elsevier Inc. All rights reserved. | ||
520 | |a 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 | ||
520 | |a 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 | ||
520 | |a 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 | ||
520 | |a 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 | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Multicenter Study | |
650 | 4 | |a Validation Study | |
700 | 1 | |a Daignault-Newton, Stephanie |e verfasserin |4 aut | |
700 | 1 | |a Heath, Gerard |e verfasserin |4 aut | |
700 | 1 | |a Scarlett, Sarah |e verfasserin |4 aut | |
700 | 1 | |a Sanda, Martin G |e verfasserin |4 aut | |
700 | 1 | |a Chang, Peter |e verfasserin |4 aut | |
700 | 1 | |a Regan, Meredith M |e verfasserin |4 aut | |
700 | 1 | |a Michalski, Jeff M |e verfasserin |4 aut | |
700 | 1 | |a Sandler, Howard M |e verfasserin |4 aut | |
700 | 1 | |a Feng, Felix Y |e verfasserin |4 aut | |
700 | 1 | |a Kuban, Deborah A |e verfasserin |4 aut | |
700 | 1 | |a Zietman, Anthony L |e verfasserin |4 aut | |
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700 | 1 | |a Kaplan, Irving D |e verfasserin |4 aut | |
700 | 1 | |a Crociani, Catrina |e verfasserin |4 aut | |
700 | 1 | |a McLaughlin, William P |e verfasserin |4 aut | |
700 | 1 | |a Mantz, Constantine A |e verfasserin |4 aut | |
700 | 1 | |a Finkelstein, Steven E |e verfasserin |4 aut | |
700 | 1 | |a Suy, Simeng |e verfasserin |4 aut | |
700 | 1 | |a Collins, Sean P |e verfasserin |4 aut | |
700 | 1 | |a Garin, Olatz |e verfasserin |4 aut | |
700 | 1 | |a Ferrer, Montserrat |e verfasserin |4 aut | |
700 | 1 | |a Hamstra, Daniel A |e verfasserin |4 aut | |
700 | 1 | |a Spratt, Daniel E |e verfasserin |4 aut | |
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