Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort study

Objective/Purpose: Hypofractionation (HF) has been established as safe in prostate cancer (PCa) trial populations. We evaluated post-treatment changes in health-related quality of life (HRQoL) outcomes after moderate (MHF) or ultra-hypofractionated (UHF) radiotherapy in a real-world PCa patient popu...

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Main Authors: W.D. Heemsbergen, F. Sinzabakira, K.C. de Vries, M. Franckena, M.E.M.C. Christianen, F.E. Froklage, H. Westerveld, L. Incrocci
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Clinical and Translational Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S240563082500045X
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author W.D. Heemsbergen
F. Sinzabakira
K.C. de Vries
M. Franckena
M.E.M.C. Christianen
F.E. Froklage
H. Westerveld
L. Incrocci
author_facet W.D. Heemsbergen
F. Sinzabakira
K.C. de Vries
M. Franckena
M.E.M.C. Christianen
F.E. Froklage
H. Westerveld
L. Incrocci
author_sort W.D. Heemsbergen
collection DOAJ
description Objective/Purpose: Hypofractionation (HF) has been established as safe in prostate cancer (PCa) trial populations. We evaluated post-treatment changes in health-related quality of life (HRQoL) outcomes after moderate (MHF) or ultra-hypofractionated (UHF) radiotherapy in a real-world PCa patient population. Methods: In this prospective cohort study, T1-4N0M0 PCa patients receiving MHF (20x3/3.1 Gy, n = 140) or UHF (7x6.1 Gy, n = 138) were assessed. UHF was not prescribed in case of T3b/T4 disease or an impaired baseline urinary function. Patients completed the EPIC urinary and bowel domains and the EQ-5D-5L (general HRQoL) at baseline and 6 months post-treatment. Thresholds for minimal clinically important differences (MCID) were defined at 8 %. Prognostic factors were assessed using regression models. Results: Proportion of the total cohort with MCID deterioration for bowel and urinary function was 20 % and 17 %, respectively. Deteriorations in bladder and bowel function significantly correlated with declined scores for general health, usual activities, pain/discomfort, and depression/anxiety. Predictive factors for urinary function deterioration at multivariable analysis were androgen deprivation therapy, age ≥ 75 year, MHF, and grade ≥ 2 acute urinary toxicity. For bowel function deterioration, no factors were identified. Conclusion: We assessed post-treatment changes in HRQoL in a clinical PCa patient population treated with MHF and UHF, and observed changes comparable to previous trial reports. Deteriorations in bowel and urinary function correlated with worse general health scores. Results for urinary function loss suggested a consequential effect of acute urinary toxicity.
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spelling doaj-art-d90548e7cc6d4e1d8ca07790ac33ee772025-08-20T03:22:11ZengElsevierClinical and Translational Radiation Oncology2405-63082025-07-015310095510.1016/j.ctro.2025.100955Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort studyW.D. Heemsbergen0F. Sinzabakira1K.C. de Vries2M. Franckena3M.E.M.C. Christianen4F.E. Froklage5H. Westerveld6L. Incrocci7Corresponding author.; Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the NetherlandsObjective/Purpose: Hypofractionation (HF) has been established as safe in prostate cancer (PCa) trial populations. We evaluated post-treatment changes in health-related quality of life (HRQoL) outcomes after moderate (MHF) or ultra-hypofractionated (UHF) radiotherapy in a real-world PCa patient population. Methods: In this prospective cohort study, T1-4N0M0 PCa patients receiving MHF (20x3/3.1 Gy, n = 140) or UHF (7x6.1 Gy, n = 138) were assessed. UHF was not prescribed in case of T3b/T4 disease or an impaired baseline urinary function. Patients completed the EPIC urinary and bowel domains and the EQ-5D-5L (general HRQoL) at baseline and 6 months post-treatment. Thresholds for minimal clinically important differences (MCID) were defined at 8 %. Prognostic factors were assessed using regression models. Results: Proportion of the total cohort with MCID deterioration for bowel and urinary function was 20 % and 17 %, respectively. Deteriorations in bladder and bowel function significantly correlated with declined scores for general health, usual activities, pain/discomfort, and depression/anxiety. Predictive factors for urinary function deterioration at multivariable analysis were androgen deprivation therapy, age ≥ 75 year, MHF, and grade ≥ 2 acute urinary toxicity. For bowel function deterioration, no factors were identified. Conclusion: We assessed post-treatment changes in HRQoL in a clinical PCa patient population treated with MHF and UHF, and observed changes comparable to previous trial reports. Deteriorations in bowel and urinary function correlated with worse general health scores. Results for urinary function loss suggested a consequential effect of acute urinary toxicity.http://www.sciencedirect.com/science/article/pii/S240563082500045XProstate cancerHypofractionationRadiotherapyEPICEQ5D5LHealth-related quality of life
spellingShingle W.D. Heemsbergen
F. Sinzabakira
K.C. de Vries
M. Franckena
M.E.M.C. Christianen
F.E. Froklage
H. Westerveld
L. Incrocci
Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort study
Clinical and Translational Radiation Oncology
Prostate cancer
Hypofractionation
Radiotherapy
EPIC
EQ5D5L
Health-related quality of life
title Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort study
title_full Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort study
title_fullStr Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort study
title_full_unstemmed Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort study
title_short Post-treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra-hypofractionation: A prospective cohort study
title_sort post treatment changes in bowel and urinary function in prostate cancer patients treated with moderate or ultra hypofractionation a prospective cohort study
topic Prostate cancer
Hypofractionation
Radiotherapy
EPIC
EQ5D5L
Health-related quality of life
url http://www.sciencedirect.com/science/article/pii/S240563082500045X
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