Noorazrul Yahya1, Martin A Ebert2, Max Bulsara3, Michael J House4, Angel Kennedy5, David J Joseph6, James W Denham7. 1. School of Physics, University of Western Australia, Australia; School of Health Sciences, National University of Malaysia, Malaysia. Electronic address: noorazrul.yahya@research.uwa.edu.au. 2. School of Physics, University of Western Australia, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Australia. 3. Institute for Health Research, University of Notre Dame, Fremantle, Australia. 4. School of Physics, University of Western Australia, Australia. 5. Department of Radiation Oncology, Sir Charles Gairdner Hospital, Australia. 6. Department of Radiation Oncology, Sir Charles Gairdner Hospital, Australia; School of Surgery, University of Western Australia, Australia. 7. School of Medicine and Public Health, University of Newcastle, Australia.
Abstract
BACKGROUND AND PURPOSE: This study aimed to compare urinary dose-symptom correlates after external beam radiotherapy of the prostate using commonly utilised peak-symptom models to multiple-event and event-count models which account for repeated events. MATERIALS AND METHODS: Urinary symptoms (dysuria, haematuria, incontinence and frequency) from 754 participants from TROG 03.04-RADAR trial were analysed. Relative (R1-R75 Gy) and absolute (A60-A75Gy) bladder dose-surface area receiving more than a threshold dose and equivalent uniform dose using exponent a (range: a ∈[1 … 100]) were derived. The dose-symptom correlates were analysed using; peak-symptom (logistic), multiple-event (generalised estimating equation) and event-count (negative binomial regression) models. RESULTS: Stronger dose-symptom correlates were found for incontinence and frequency using multiple-event and/or event-count models. For dysuria and haematuria, similar or better relationships were found using peak-symptom models. Dysuria, haematuria and high grade (⩾ 2) incontinence were associated to high dose (R61-R71 Gy). Frequency and low grade (⩾ 1) incontinence were associated to low and intermediate dose-surface parameters (R13-R41Gy). Frequency showed a parallel behaviour (a=1) while dysuria, haematuria and incontinence showed a more serial behaviour (a=4 to a ⩾ 100). Relative dose-surface showed stronger dose-symptom associations. CONCLUSIONS: For certain endpoints, the multiple-event and event-count models provide stronger correlates over peak-symptom models. Accounting for multiple events may be advantageous for a more complete understanding of urinary dose-symptom relationships.
BACKGROUND AND PURPOSE: This study aimed to compare urinary dose-symptom correlates after external beam radiotherapy of the prostate using commonly utilised peak-symptom models to multiple-event and event-count models which account for repeated events. MATERIALS AND METHODS: Urinary symptoms (dysuria, haematuria, incontinence and frequency) from 754 participants from TROG 03.04-RADAR trial were analysed. Relative (R1-R75 Gy) and absolute (A60-A75Gy) bladder dose-surface area receiving more than a threshold dose and equivalent uniform dose using exponent a (range: a ∈[1 … 100]) were derived. The dose-symptom correlates were analysed using; peak-symptom (logistic), multiple-event (generalised estimating equation) and event-count (negative binomial regression) models. RESULTS: Stronger dose-symptom correlates were found for incontinence and frequency using multiple-event and/or event-count models. For dysuria and haematuria, similar or better relationships were found using peak-symptom models. Dysuria, haematuria and high grade (⩾ 2) incontinence were associated to high dose (R61-R71 Gy). Frequency and low grade (⩾ 1) incontinence were associated to low and intermediate dose-surface parameters (R13-R41Gy). Frequency showed a parallel behaviour (a=1) while dysuria, haematuria and incontinence showed a more serial behaviour (a=4 to a ⩾ 100). Relative dose-surface showed stronger dose-symptom associations. CONCLUSIONS: For certain endpoints, the multiple-event and event-count models provide stronger correlates over peak-symptom models. Accounting for multiple events may be advantageous for a more complete understanding of urinary dose-symptom relationships.
Authors: Sangkyu Lee; Sarah Kerns; Harry Ostrer; Barry Rosenstein; Joseph O Deasy; Jung Hun Oh Journal: Int J Radiat Oncol Biol Phys Date: 2018-01-31 Impact factor: 7.038
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Authors: Marco Marcello; James W Denham; Angel Kennedy; Annette Haworth; Allison Steigler; Peter B Greer; Lois C Holloway; Jason A Dowling; Michael G Jameson; Dale Roach; David J Joseph; Sarah L Gulliford; David P Dearnaley; Matthew R Sydes; Emma Hall; Martin A Ebert Journal: Front Oncol Date: 2020-07-22 Impact factor: 6.244