A European cross-cultural analysis of worsening of functional scales in prostate cancer patients after RT
Cicchetti, A. Joseph, N. Seibold, P. Avuzzi, B. Valdagni, R. Webb, A. De Ruysscher, D. Lambrecht, M. Sperk, E. Elliott, Rebecca M
Cicchetti, A.
Joseph, N.
Seibold, P.
Avuzzi, B.
Valdagni, R.
Webb, A.
De Ruysscher, D.
Lambrecht, M.
Sperk, E.
Elliott, Rebecca M
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Abstract
Purpose or Objective
The study aimed to evaluate the deterioration of functional outcomes in localized prostate cancer (PCa)
patients (pts) treated with external beam radiotherapy (RT), including analysis of differences possibly due to
cultural effects.
Materials and Methods
EORTC QLQ-C30 (version 3.0) was administered to pts enrolled in a multicenter prospective observational
study in 7 European countries (UK, BE, NH, DE, IT, ES, FR). For this analysis, we specifically considered one
symptom scale (Fatigue) and three functional scales (Physical, Role, Social) at three time-points: baseline, RT
end and 2-year after RT. The average score variation in acute and late phases as stratified by country was
determined. We used radar plots to report results quantitatively, and we computed the hexagonal areas from
these plots to obtain a summary variable describing the functional status. Worsening in at least 2 (wrs2) or 3 (wrs3) scales were considered as further endpoints, with cut-offs for clinically significant deterioration
defined as suggested by Cooks et al. (EJC 2012).
Results
A total of 1143 pts with complete information were available. Figure 1 shows radar plots with scores for the
different scales. Physical functioning is the only scale that deteriorates at each time point (ageing effect?) in
every country. Table 1 reports scores, hexagonal areas and the prevalence of wrs2/wrs3 as a function of
country and time-points. The ratio of hexagonal areas “(at RT end)/(at 2-year)” is reported as an index for
recovery of acute effects. Spanish Ratio (<1) shows a continuous deterioration with time. Wrs 2 and wrs3 at
the end of RT were found in 31% (range 13% in ES – 45% in NH) and 16% (range 6% in ES – 23% in NH) of pts,
respectively. Prevalence of wrs2 at 2 years was 23% (range 15% in IT – 28% in BE and NH), while wrs3 was 12%
(range 11% in IT – 16% in NH). Conclusion
Results from the EORTC QLQ-C30 highlighted a large variability across countries in the deterioration of
functional scales at the end of RT (acute/early phase), with differences highly reduced at 2 years (late phase).
Of note, there is a consequential effect in the deterioration of functional scales, with about two-thirds of
patients with deterioration at RT end who did not recover after 2 years.
Description
Date
2021
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Cicchetti A, Joseph N, Seibold P, Avuzzi B, Valdagni R, Webb A, et al. An European cross-cultural analysis of worsening of functional scales in prostate cancer patients after RT. Radiotherapy and Oncology. 2021;161:S765-S6.