open access

Vol 23, No 5 (2018)
Original research articles
Published online: 2018-09-01
Submitted: 2018-02-21
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Association between EBRT dose volume histograms and quality of life in prostate cancer patients

Anna Boladeras, Ferran Ferrer, Valentin Navarro, Rodolfo De Blas, Oriol Cunillera, David Mateo, Cristina Gutierrez, Evelyn Martinez, Salvador Villà, Joan Pera, Montse Ferrer, Ferran Guedea
DOI: 10.1016/j.rpor.2018.07.009
·
Rep Pract Oncol Radiother 2018;23(5):360-368.

open access

Vol 23, No 5 (2018)
Original research articles
Published online: 2018-09-01
Submitted: 2018-02-21

Abstract

Aim

To evaluate the association between dose–volume histogram (DVH) values in organs at risk (OAR) and patient-reported HRQoL outcomes.

Background

Data on the association between DVHs and health-related quality of life (HRQoL) in prostate cancer (PCa) patients are limited.

Materials and methods

Five-year follow-up study of 154 patients with organ-confined (stage T1/T2) PCa treated with EBRT between January 2003 and November 2005. HRQoL was evaluated with the Expanded Prostate Cancer Index (EPIC). DVH for OARs (penile bulb, rectum and bladder) were created for all patients for whom data were available (119/154; 77%). The functional data analysis (FDA) statistical method was used. HRQoL data was collected prospectively and data analysis was performed retrospectively.

Results

Worsening of urinary incontinence and obstructive symptoms correlated with higher DVH dose distributions at 24 months. Increased rectal bleeding at months 24 and 60 correlated with higher DVH dose distributions in the 40–70 Gy range. Patients with deterioration in rectal incontinence presented a higher DVH distribution range than patients without rectal incontinence. Penile bulb DVH values and erectile dysfunction were not significantly associated.

Conclusions

DVH parameters and post-radiotherapy HRQoL appear to be closely correlated, underscoring the importance of assessing DVH values prior to initiating EBRT to determine the risk of developing HRQoL related adverse effects. Advanced treatment modalities may be appropriate in high risk cases to minimize treatment-related toxicity and to improve treatment outcomes and HRQoL. Future studies are needed to better elucidate the association between pre-treatment DVH parameters in organs at risk and subsequent HRQoL.

Abstract

Aim

To evaluate the association between dose–volume histogram (DVH) values in organs at risk (OAR) and patient-reported HRQoL outcomes.

Background

Data on the association between DVHs and health-related quality of life (HRQoL) in prostate cancer (PCa) patients are limited.

Materials and methods

Five-year follow-up study of 154 patients with organ-confined (stage T1/T2) PCa treated with EBRT between January 2003 and November 2005. HRQoL was evaluated with the Expanded Prostate Cancer Index (EPIC). DVH for OARs (penile bulb, rectum and bladder) were created for all patients for whom data were available (119/154; 77%). The functional data analysis (FDA) statistical method was used. HRQoL data was collected prospectively and data analysis was performed retrospectively.

Results

Worsening of urinary incontinence and obstructive symptoms correlated with higher DVH dose distributions at 24 months. Increased rectal bleeding at months 24 and 60 correlated with higher DVH dose distributions in the 40–70 Gy range. Patients with deterioration in rectal incontinence presented a higher DVH distribution range than patients without rectal incontinence. Penile bulb DVH values and erectile dysfunction were not significantly associated.

Conclusions

DVH parameters and post-radiotherapy HRQoL appear to be closely correlated, underscoring the importance of assessing DVH values prior to initiating EBRT to determine the risk of developing HRQoL related adverse effects. Advanced treatment modalities may be appropriate in high risk cases to minimize treatment-related toxicity and to improve treatment outcomes and HRQoL. Future studies are needed to better elucidate the association between pre-treatment DVH parameters in organs at risk and subsequent HRQoL.

Get Citation

Keywords

Organs at risk; Prostatic neoplasms; Quality of life; Urinary bladder; Urinary incontinence

About this article
Title

Association between EBRT dose volume histograms and quality of life in prostate cancer patients

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 5 (2018)

Pages

360-368

Published online

2018-09-01

DOI

10.1016/j.rpor.2018.07.009

Bibliographic record

Rep Pract Oncol Radiother 2018;23(5):360-368.

Keywords

Organs at risk
Prostatic neoplasms
Quality of life
Urinary bladder
Urinary incontinence

Authors

Anna Boladeras
Ferran Ferrer
Valentin Navarro
Rodolfo De Blas
Oriol Cunillera
David Mateo
Cristina Gutierrez
Evelyn Martinez
Salvador Villà
Joan Pera
Montse Ferrer
Ferran Guedea

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