1
|
Sanguineti G, Pavarini M, Munoz F, Magli A, Cante D, Garibaldi E, Gebbia A, Noris Chiorda B, Girelli G, Villa E, Faiella A, Magdalena Waskiewicz J, Avuzzi B, Pastorino A, Moretti E, Rago L, Statuto T, Gatti M, Rancati T, Valdagni R, Luigi Vavassori V, Gisella Di Muzio N, Fiorino C, Cozzarini C. Worsening of 2-year patient-reported intestinal functionality after radiotherapy for prostate cancer including pelvic node irradiation. Radiother Oncol 2024; 192:110088. [PMID: 38199284 DOI: 10.1016/j.radonc.2024.110088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND AND PURPOSE To quantify patient-reported 2-year intestinal toxicity (IT) from pelvic nodal irradiation (PNI) for prostate cancer. The association between baseline/acute symptoms and 2-year worsening was investigated. MATERIALS AND METHODS Patient-reported IT was prospectively assessed through the Inflammatory Bowel Disease Questionnaire (IBDQ), filled in at baseline, radiotherapy mid-point and end, at 3 and 6 months and every 6 months until 5 years. Two-year deterioration of IBDQ scores relative to the Bowel Domain was investigated for 400 patients with no severe baseline symptoms and with questionnaires available at baseline, 2 years, RT mid-point and/or end and at least three follow-ups between 3 and 18 months. The significance of the 2-year differences from baseline was tested. The association between baseline values and ΔAcute (the worst decline between baseline and RT mid-point/end) was investigated. RESULTS In the IBDQ lower scores indicate worse symptoms. A significant (p < 0.0001) 2-year mean worsening, mostly in the range of -0.2/-0.4 points on a 1-7 scale, emerged excepting one question (IBDQ29, "nausea/feeling sick"). This decline was independent of treatment intent while baseline values were associated with 2-year absolute scores. The ΔAcute largely modulated 2-year worsening: patients with ΔAcute greater than the first quartile (Q1) and ΔAcute less or equal than Q1 showed no/minimal and highly significant (p < 0.0001) deterioration, respectively. Rectal incontinence, urgency, frequency and abdominal pain showed the largest mean changes (-0.5/-1): risk of severe worsening (deemed to be of clinical significance if ≤ 2) was 3-5 fold higher in the ΔAcute ≤ Q1 vs ΔAcute > Q1 group (p < 0.0001). CONCLUSION A modest but significant deterioration of two-year patient-reported intestinal symptoms from PNI compared to baseline was found. Patients experiencing more severe acute symptoms are at higher risk of symptom persistence at 2 years, with a much larger prevalence of clinically significant symptoms.
Collapse
Affiliation(s)
- Giuseppe Sanguineti
- Radiotherapy, IRCCS Istituto Nazionale dei Tumori "Regina Elena", Roma, Italy
| | | | - Fernando Munoz
- Radiotherapy, Ospedale Regionale Parini-AUSL Valle d'Aosta, Aosta, Italy
| | - Alessandro Magli
- Radiotherapy, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy
| | | | | | - Andrea Gebbia
- Medical Physics, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | | | | | - Elisa Villa
- Radiotherapy, Cliniche Gavazzeni-Humanitas, Bergamo, Italy
| | - Adriana Faiella
- Radiotherapy, IRCCS Istituto Nazionale dei Tumori "Regina Elena", Roma, Italy
| | | | - Barbara Avuzzi
- Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Eugenia Moretti
- Medical Physics, Azienda sanitaria universitaria Friuli Centrale, Udine, Italy
| | - Luciana Rago
- Radiotherapy, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), Rionero in Vulture, Italy
| | - Teodora Statuto
- Laboratory of Clinical Research and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS - CROB), Rionero in Vulture, Italy
| | - Marco Gatti
- Radiotherapy, Istituto di Candiolo - Fondazione del Piemonte per l'Oncologia IRCCS, Candiolo, Italy
| | - Tiziana Rancati
- Unit of Data Science, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Riccardo Valdagni
- Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Nadia Gisella Di Muzio
- Radiotherapy, IRCCS San Raffaele Scientific Institute, Milano, Italy; Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
| | - Claudio Fiorino
- Medical Physics, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Cesare Cozzarini
- Radiotherapy, IRCCS San Raffaele Scientific Institute, Milano, Italy.
| |
Collapse
|
2
|
Fairweather D, Taylor RM, Simões R. Choosing the right questions - A systematic review of patient reported outcome measures used in radiotherapy and proton beam therapy. Radiother Oncol 2024; 191:110071. [PMID: 38142933 DOI: 10.1016/j.radonc.2023.110071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/01/2023] [Accepted: 12/16/2023] [Indexed: 12/26/2023]
Abstract
The implementation of PROMs into clinical practice has been shown to improve quality of care. This systematic review aims to identify which PROMs are suitable for implementation within routine clinical practice in a radiotherapy or PBT service.The bibliographic databases MEDLINE, EMBASE and EMCARE were searched. Articles published between 1st January 2008 to 1st June 2023, that reported PROMs being utilised as an outcome measure were included. Inclusion criteria also included being written in English, involving human patients, aged 16 and above, receiving external beam radiotherapy or PBT for six defined tumour sites. PROMs identified within the included articles were subjected to quality assessment using the COSMIN reporting guidelines. Results are reported as per PRISMA guidelines. A total of 268 studies were identified in the search, of which 52 fulfilled the inclusion criteria. The use of 39 different PROMs was reported. The PROMs identified were mostly tumour or site-specific quality of life (n = 23) measures but also included generic cancer (n = 3), health-related quality-of-life (n = 6), and symptom specific (n = 7) measures.None of the PROMs identified received a high GRADE score for good content. There were 13 PROMs that received a moderate GRADE score. The remaining PROMs either had limited evidence of development and validation within the patient cohorts investigated, or lacked relevance or comprehensiveness needed for routine PROMs collection in a radiotherapy or PBT service.This review highlights that there are a wide variety of PROMs being utilised within radiotherapy research, but most lack specificity to radiotherapy side-effects. There is a risk that by using non-specific PROMs in clinical practice, patients might not receive the supportive care that they need.
Collapse
Affiliation(s)
- Danielle Fairweather
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.
| | - Rachel M Taylor
- Centre for Nurse, Midwife and Allied Health Profession Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK; Department of Targeted Intervention, University College London, London, UK
| | - Rita Simões
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK; Radiotherapy Trials Quality Assurance (RTTQA) group, Mount Vernon Hospital, Northwood, UK
| |
Collapse
|
3
|
Biran A, Bolnykh I, Rimmer B, Cunliffe A, Durrant L, Hancock J, Ludlow H, Pedley I, Rees C, Sharp L. A Systematic Review of Population-Based Studies of Chronic Bowel Symptoms in Cancer Survivors following Pelvic Radiotherapy. Cancers (Basel) 2023; 15:4037. [PMID: 37627064 PMCID: PMC10452492 DOI: 10.3390/cancers15164037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Pelvic radiotherapy can damage surrounding tissue and organs, causing chronic conditions including bowel symptoms. We systematically identified quantitative, population-based studies of patient-reported bowel symptoms following pelvic radiotherapy to synthesize evidence of symptom type, prevalence, and severity. Medline, CINAHL, EMBASE, and PsychINFO were searched from inception to September 2022. Following independent screening of titles, abstracts, and full-texts, population and study characteristics and symptom findings were extracted, and narrative synthesis was conducted. In total, 45 papers (prostate, n = 39; gynecological, n = 6) reporting 19 datasets were included. Studies were methodologically heterogeneous. Most frequently assessed was bowel function ('score', 26 papers, 'bother', 19 papers). Also assessed was urgency, diarrhea, bleeding, incontinence, abdominal pain, painful hemorrhoids, rectal wetness, constipation, mucous discharge, frequency, and gas. Prevalence ranged from 1% (bleeding) to 59% (anal bleeding for >12 months at any time since start of treatment). In total, 10 papers compared radiotherapy with non-cancer comparators and 24 with non-radiotherapy cancer patient groups. Symptom prevalence/severity was greater/worse in radiotherapy groups and symptoms more common/worse post-radiotherapy than pre-diagnosis/treatment. Symptom prevalence varied between studies and symptoms. This review confirms that many people experience chronic bowel symptoms following pelvic radiotherapy. Greater methodological consistency, and investigation of less-well-studied survivor populations, could better inform the provision of services and support.
Collapse
Affiliation(s)
- Adam Biran
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (I.B.); (B.R.); (C.R.); (L.S.)
| | - Iakov Bolnykh
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (I.B.); (B.R.); (C.R.); (L.S.)
| | - Ben Rimmer
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (I.B.); (B.R.); (C.R.); (L.S.)
| | - Anthony Cunliffe
- NHS Southwest London Clinical Commissioning Group, London SW19 1RH, UK;
| | - Lisa Durrant
- Somerset NHS Foundation Trust, Taunton TA1 5DA, UK;
| | - John Hancock
- North Tees and Hartlepool NHS Foundation Trust, Hartlepool TS24 9AH, UK;
| | - Helen Ludlow
- Llandough, Cardiff and Vale University Health Board, Cardiff CF64 2XX, UK;
| | - Ian Pedley
- Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne NE3 3HD, UK;
| | - Colin Rees
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (I.B.); (B.R.); (C.R.); (L.S.)
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (I.B.); (B.R.); (C.R.); (L.S.)
| |
Collapse
|
4
|
Supiot S, Ah-Thiane L, Rousseau C. Sentinel Lymph Node Biopsy: A Great Opportunity for Personalized Radiotherapy in Prostate Cancer. EUR UROL SUPPL 2023; 49:51-52. [PMID: 36793751 PMCID: PMC9922764 DOI: 10.1016/j.euros.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 01/29/2023] Open
Affiliation(s)
- Stéphane Supiot
- Department of Radiotherapy, ICO René Gauducheau, Saint-Herblain, France,Nantes University, Nantes, France,Corresponding author. Service de Radiothérapie, Institut de Cancérologie de l’Ouest René Gauducheau, Boulevard du Professeur Jacques Monod, 44800 Saint-Herblain, France. Tel. +33 2 4067 9913.
| | - Loic Ah-Thiane
- Department of Radiotherapy, ICO René Gauducheau, Saint-Herblain, France
| | - Caroline Rousseau
- Department of Nuclear Medicine, ICO René Gauducheau, Saint-Herblain, France,CRCI2NA, UMR 1307 Inserm-UMR 6075 CNRS, Nantes University, Nantes, France
| |
Collapse
|
5
|
Jensen GL, Jhavar SG, Ha CS, Hammonds KP, Swanson GP. The cost of elective nodal coverage in prostate cancer: Late quality of life outcomes and dosimetric analysis with 0, 45 or 54 Gy to the pelvis. Clin Transl Radiat Oncol 2022; 36:63-69. [PMID: 35813937 PMCID: PMC9256976 DOI: 10.1016/j.ctro.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022] Open
Abstract
Pelvic nodal radiation to 54 Gy correlates with worse urinary quality of life. Pelvic nodal radiation to 45 Gy does not correlate with urinary quality of life. Post-operative radiation resulted in greater urinary quality of life decline. Pelvic nodal radiation did not correlate with bowel quality of life.
Purpose Elective pelvic lymph node radiotherapy (PLNRT) in prostate cancer is often omitted from definitive (n = 267) and post prostatectomy (n = 160) radiotherapy (RT) due to concerns regarding toxicity and efficacy. Data comparing patient-reported outcome measures (PROMs) with or without PLNRT is limited. Our long-term supposition is that PLNRT, particularly to higher doses afforded by IMRT, will decrease pelvic failure rate in select patients. We aim to establish the impact of two different PLNRT doses on long term quality of life (QOL). Methods and materials Prostate cancer patients (n = 428) recorded baseline scores using the Expanded Prostate Cancer Index Composite (EPIC), prior to definitive or post-prostatectomy RT. PLNRT, if given, was prescribed to 45 or 54 Gy at 1.8 Gy per fraction. New EPIC scores were recorded 20–36 months after radiotherapy. Absolute change in each domain subscale and summary score was recorded, along with if these changes met minimally important difference (MID) criteria. A separate multivariate analysis (MVA) was performed for each measure. Subsequent dosimetric analysis was performed. Results Frequency of a MID decline was significantly greater with PLNRT to 54 Gy for urinary function, incontinence, and overall. No urinary decline was correlated with PLNRT to 45 Gy. PLNRT to 54 Gy was significant for decline in urinary function, bother, irritative, incontinence, and overall score in one or both MVA models while 45 Gy was not. Postoperative status was significant for decline in urinary function, incontinence, and overall. Amongst postoperative patients, there was significantly greater decline in urinary function score in the salvage setting. Neither 54 nor 45 Gy significantly affected bowel subscale or overall score decline. Conclusions Using conventional fractionation, adding PLNRT to 54 Gy, but not 45 Gy, correlates with worse urinary QOL, with postoperative patients experiencing a steeper decline. PLNRT had no significant impact on bowel QOL with either dose.
Collapse
Affiliation(s)
- Garrett L. Jensen
- Departments of Radiation Oncology, Baylor Scott & White Health, 2401 S. 31st St., Temple, TX 76508, USA
| | - Sameer G. Jhavar
- Departments of Radiation Oncology, Baylor Scott & White Health, 2401 S. 31st St., Temple, TX 76508, USA
| | - Chul S Ha
- Department of Radiation Oncology, UT Health San Antonio, 8300 Floyd Curl Dr., San Antonio, TX 78229, USA
| | - Kendall P. Hammonds
- Departments of Biostatistics, Baylor Scott & White Health, 2401 S. 31st St., Temple, TX 76508, USA
| | - Gregory P. Swanson
- Departments of Radiation Oncology, Baylor Scott & White Health, 2401 S. 31st St., Temple, TX 76508, USA
- Corresponding author.
| |
Collapse
|
6
|
Wallis CJ, Huang LC, Zhao Z, Penson DF, Koyama T, Conwill R, Tallman JE, Goodman M, Hamilton AS, Wu XC, Paddock LE, Stroup A, Cooperberg MR, Hashibe M, O’Neil BB, Kaplan SH, Greenfield S, Barocas DA, Hoffman KE. Association between pelvic nodal radiotherapy and patient-reported functional outcomes through 5 years among men undergoing external-beam radiotherapy for prostate cancer: An assessment of the comparative effectiveness analysis of surgery and radiation (CEASAR) cohort. Urol Oncol 2022; 40:56.e1-56.e8. [PMID: 34154899 PMCID: PMC9933913 DOI: 10.1016/j.urolonc.2021.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The role of pelvic irradiation in men receiving external beam radiotherapy (EBRT) for prostate cancer is unclear, in part due to a lack of data on patient-reported outcomes. We sought to compare functional outcomes for men receiving prostate and pelvic versus prostate-only radiotherapy, longitudinally over 5 years. MATERIALS AND METHODS We performed a population-based, prospective cohort study of men with clinically-localized prostate cancer undergoing EBRT. We examined the effect of prostate and pelvic (n = 102) versus prostate-only (n = 485) radiotherapy on patient-reported disease-specific (using the Expanded Prostate Cancer Index Composite[EPIC]-26) and general health-related (using the SF-36) function, over 5 years. Regression models were adjusted for outcome-specific baseline function, clinicopathologic characteristics, and androgen deprivation therapy (ADT). RESULTS 587 men (median [quartiles] age 69 [64-73] years) met inclusion criteria and completed ≥1 post-treatment survey. More men treated with prostate and pelvic radiotherapy had high-risk disease (58% vs. 18%, P < 0.01) and received ADT (75% vs. 41%, P < 0.01). These men reported worse sexual (6 months-5 years), hormonal (at 6 months), and physical (6 months-5 years) function. Accounting for baseline function, patient and tumor characteristics, and use of ADT, pelvic irradiation was not associated with statistically or clinically significant differences in bowel function, urinary incontinence, irritative voiding symptoms or sexual function through 5-years (all P > 0.05). Marginally clinically important differences were noted in hormonal function at 3-years (adjusted mean difference 4.7, 95% confidence interval [1.2-8.3]; minimally clinically important difference (MCID) 4 to 6) and 5-years (4.2, [0.4-8.0]) following treatment. After adjustment, there was a transient statistically significant, but not clinically important, difference in emotional well-being at 6 months (3.0, [0.19-5.8]; MCID 6) that resolved by 1 year and no differences in physical functioning or energy and fatigue. CONCLUSION This prospective, population-based cohort study of men with localized prostate cancer treated with EBRT, showed no clinically important differences in disease-specific or general health-related quality of life with the addition of pelvic irradiation to prostate radiotherapy, supporting the use of pelvic radiotherapy when it may be of clinical benefit, such as men with increased risk of nodal involvement.
Collapse
Affiliation(s)
| | - Li-Ching Huang
- Department of Biostatistics, Vanderbilt University Medical Center
| | - Zhiguo Zhao
- Department of Biostatistics, Vanderbilt University Medical Center
| | | | - Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University Medical Center
| | - Ralph Conwill
- Office of Patient and Community Education, Patient Advocacy Program, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center
| | | | - Michael Goodman
- Department of Epidemiology, Emory University Rollins School of Public Health
| | - Ann S. Hamilton
- Department of Preventative Medicine, Keck School of Medicine at the University of Southern California
| | - Xiao-Cheng Wu
- Department of Epidemiology, Louisiana State University New Orleans School of Public Health
| | - Lisa E. Paddock
- Department of Epidemiology, Cancer Institute of New Jersey, Rutgers Health
| | - Antoinette Stroup
- Department of Epidemiology, Cancer Institute of New Jersey, Rutgers Health
| | | | - Mia Hashibe
- Department of Family and Preventative Medicine, University of Utah School of Medicine
| | | | | | | | | | - Karen E. Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Center
| |
Collapse
|
7
|
Murthy V, Srinivasan S. In Regard to Parry et al. Int J Radiat Oncol Biol Phys 2021; 110:918. [PMID: 34089691 DOI: 10.1016/j.ijrobp.2021.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/24/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Mumbai, India
| | - Shashank Srinivasan
- Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|
8
|
Onderdonk BE, Dorn PL, Martinez C, Arif F, Cloutier D, Antic T, Golden DW, Karrison T, Pitroda SP, Szmulewitz RZ, Liauw SL. A prospective clinical and transcriptomic feasibility study of oral-only hormonal therapy with radiation for unfavorable prostate cancer in men 70 years of age and older or with comorbidity. Cancer 2021; 127:2631-2640. [PMID: 33882144 DOI: 10.1002/cncr.33556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/05/2021] [Accepted: 03/04/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Androgen deprivation therapy (ADT) improves outcomes in unfavorable-risk prostate cancer (PCa) treated with radiation therapy (RT). It was hypothesized that replacing luteinizing hormone-releasing hormone (LHRH) agonists with a 5-α-reductase inhibitor (5-ARI) would improve hormonal health-related quality of life (HRQOL) without differentially suppressing androgen-responsive (AR) gene expression. METHODS Patients with localized unfavorable-risk PCa, aged ≥70 years or Charlson Comorbidity Index score ≥2 were treated with oral ADT (oADT), consisting of 4 months of bicalutamide, a 5-ARI, and RT at 78 Gy. The primary end point was Expanded Prostate Cancer Index Composite HRQOL at 6 months ≤30%, and improvement compared with a synchronous standard of care (SOC) cohort receiving 4 months of bicalutamide and long-term LHRH agonist with RT. RNA sequencing was performed from matched pre-/post-ADT prostate tumor biopsies in a subset of men. Differential gene and pathway expressional changes were examined using gene set enrichment. RESULTS Between 2011 and 2018, 40 and 30 men were enrolled in the oADT and SOC cohorts, respectively. Median follow-up was 40 months. Those with ≤30% decline in hormonal HRQOL at 6 months was 97% (oADT) and 93% (SOC). The average 6-month hormonal decline was 1% (oADT) versus 12% (SOC; P = .04). The 4-year freedom from biochemical failure was 88% (oADT) versus 81% (SOC; P = .48). RNA sequencing (n = 9) showed similar numbers of downregulated and upregulated genes between the treatment groups (fold-change = 2; false-discovery rate-adjusted P ≤ .05). Both treatments comparably decreased the expression of 20 genes in canonical androgen receptor signaling. CONCLUSIONS For men with PCa undergoing RT, oral versus standard ADT may improve 6-month QOL and appears to have a similar impact on androgen-responsive gene expression.
Collapse
Affiliation(s)
- Benjamin E Onderdonk
- Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois
| | - Paige L Dorn
- Rose Medical Center Radiation Oncology, Denver, Colorado
| | - Carlos Martinez
- Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois
| | - Fauzia Arif
- Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois
| | - Denise Cloutier
- Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois
| | - Tatjana Antic
- Department of Pathology, University of Chicago Medicine, Chicago, Illinois
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois
| | - Theodore Karrison
- Department of Biostatistics, University of Chicago Medicine, Chicago, Illinois
| | - Sean P Pitroda
- Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois
| | | | - Stanley L Liauw
- Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois
| |
Collapse
|