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000182686 1001_ $$aJoseph, Nuradh$$b0
000182686 245__ $$aHigh weekly integral dose and larger fraction size increase risk of fatigue and worsening of functional outcomes following radiotherapy for localized prostate cancer.
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000182686 520__ $$aWe hypothesized that increasing the pelvic integral dose (ID) and a higher dose per fraction correlate with worsening fatigue and functional outcomes in localized prostate cancer (PCa) patients treated with external beam radiotherapy (EBRT).The study design was a retrospective analysis of two prospective observational cohorts, REQUITE (development, n=543) and DUE-01 (validation, n=228). Data were available for comorbidities, medication, androgen deprivation therapy, previous surgeries, smoking, age, and body mass index. The ID was calculated as the product of the mean body dose and body volume. The weekly ID accounted for differences in fractionation. The worsening (end of radiotherapy versus baseline) of European Organisation for Research and Treatment of Cancer EORTC) Quality of Life Questionnaire (QLQ)-C30 scores in physical/role/social functioning and fatigue symptom scales were evaluated, and two outcome measures were defined as worsening in ≥2 (WS2) or ≥3 (WS3) scales, respectively. The weekly ID and clinical risk factors were tested in multivariable logistic regression analysis.In REQUITE, WS2 was seen in 28% and WS3 in 16% of patients. The median weekly ID was 13.1 L·Gy/week [interquartile (IQ) range 10.2-19.3]. The weekly ID, diabetes, the use of intensity-modulated radiotherapy, and the dose per fraction were significantly associated with WS2 [AUC (area under the receiver operating characteristics curve) =0.59; 95% CI 0.55-0.63] and WS3 (AUC=0.60; 95% CI 0.55-0.64). The prevalence of WS2 (15.3%) and WS3 (6.1%) was lower in DUE-01, but the median weekly ID was higher (15.8 L·Gy/week; IQ range 13.2-19.3). The model for WS2 was validated with reduced discrimination (AUC=0.52 95% CI 0.47-0.61), The AUC for WS3 was 0.58.Increasing the weekly ID and the dose per fraction lead to the worsening of fatigue and functional outcomes in patients with localized PCa treated with EBRT.
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000182686 650_7 $$2Other$$afatigue
000182686 650_7 $$2Other$$afunctional loss
000182686 650_7 $$2Other$$aintegral dose
000182686 650_7 $$2Other$$aprostate cancer
000182686 650_7 $$2Other$$aradiotherapy - adverse effects
000182686 7001_ $$aCicchetti, Alessandro$$b1
000182686 7001_ $$aMcWilliam, Alan$$b2
000182686 7001_ $$aWebb, Adam$$b3
000182686 7001_ $$0P:(DE-He78)fd17a8dbf8d08ea5bb656dfef7398215$$aSeibold, Petra$$b4$$udkfz
000182686 7001_ $$aFiorino, Claudio$$b5
000182686 7001_ $$aCozzarini, Cesare$$b6
000182686 7001_ $$aVeldeman, Liv$$b7
000182686 7001_ $$aBultijnck, Renée$$b8
000182686 7001_ $$aFonteyne, Valérie$$b9
000182686 7001_ $$aTalbot, Christopher J$$b10
000182686 7001_ $$aSymonds, Paul R$$b11
000182686 7001_ $$aJohnson, Kerstie$$b12
000182686 7001_ $$aRattay, Tim$$b13
000182686 7001_ $$aLambrecht, Maarten$$b14
000182686 7001_ $$aHaustermans, Karin$$b15
000182686 7001_ $$aDe Meerleer, Gert$$b16
000182686 7001_ $$aElliott, Rebecca M$$b17
000182686 7001_ $$aSperk, Elena$$b18
000182686 7001_ $$aHerskind, Carsten$$b19
000182686 7001_ $$aVeldwijk, Marlon$$b20
000182686 7001_ $$aAvuzzi, Barbara$$b21
000182686 7001_ $$aGiandini, Tommaso$$b22
000182686 7001_ $$aValdagni, Riccardo$$b23
000182686 7001_ $$aAzria, David$$b24
000182686 7001_ $$aJacquet, Marie-Pierre Farcy$$b25
000182686 7001_ $$aCharissoux, Marie$$b26
000182686 7001_ $$aVega, Ana$$b27
000182686 7001_ $$aAguado-Barrera, Miguel E$$b28
000182686 7001_ $$aGómez-Caamaño, Antonio$$b29
000182686 7001_ $$aFranco, Pierfrancesco$$b30
000182686 7001_ $$aGaribaldi, Elisabetta$$b31
000182686 7001_ $$aGirelli, Giuseppe$$b32
000182686 7001_ $$aIotti, Cinzia$$b33
000182686 7001_ $$aVavassori, Vittotorio$$b34
000182686 7001_ $$0P:(DE-He78)c259d6cc99edf5c7bc7ce22c7f87c253$$aChang-Claude, Jenny$$b35$$udkfz
000182686 7001_ $$aWest, Catharine M L$$b36
000182686 7001_ $$aRancati, Tiziana$$b37
000182686 7001_ $$aChoudhury, Ananya$$b38
000182686 773__ $$0PERI:(DE-600)2649216-7$$a10.3389/fonc.2022.937934$$gVol. 12, p. 937934$$p937934$$tFrontiers in oncology$$v12$$x2234-943X$$y2022
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