TY - JOUR
T1 - A Comparison between Patient-and Physician-Reported Late Radiation Toxicity in Long-Term Prostate Cancer Survivors
AU - Nuijens, Anna C.
AU - Oei, Arlene L.
AU - Bouhuijs, Anne
AU - Franken, Nicolaas A. P.
AU - Rasch, Coen R. N.
AU - Stalpers, Lukas J. A.
N1 - Funding Information: Funding: This research was funded by the Dutch Cancer Society (KWF projects UVA 2008-4019 and 11000) and the Stichting Vanderes. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Patient-reported outcome measures (PROMs) are advocated for the monitoring of toxicity after radiotherapy. However, studies comparing physician-and patient-reported toxicity show low concordance. In this study, we compared physician-and patient-reported toxicity in long-term prostate cancer survivors after radiotherapy, and we determined the correlation with a presumable risk factor for late toxicity: γ-H2AX foci decay ratio (FDR). Patients formerly included in a prospective study were invited to participate in this new study, comprising one questionnaire and one call with a trial physician assistant. Concordance was calculated for seven symptoms. Gamma-H2AX FDRs were determined in ex vivo irradiated lymphocytes in a previous analysis. Associations between FDR and long-term prevalence of toxicity were assessed using univariable logistic regression analyses. The 101 participants had a median follow-up period of 9 years. Outcomes were discordant in 71% of symptomatic patients; in 21%, the physician-assessed toxicity (using CTCAE) was higher, and, in 50%, the patients reported higher toxicity. We did not find a correlation between presence of toxicity at long-term follow-up and FDR. In conclusion, patients assigned greater severity to symptoms than the trial physician assistant did. Consideration of both perspectives may be warranted to provide the best care.
AB - Patient-reported outcome measures (PROMs) are advocated for the monitoring of toxicity after radiotherapy. However, studies comparing physician-and patient-reported toxicity show low concordance. In this study, we compared physician-and patient-reported toxicity in long-term prostate cancer survivors after radiotherapy, and we determined the correlation with a presumable risk factor for late toxicity: γ-H2AX foci decay ratio (FDR). Patients formerly included in a prospective study were invited to participate in this new study, comprising one questionnaire and one call with a trial physician assistant. Concordance was calculated for seven symptoms. Gamma-H2AX FDRs were determined in ex vivo irradiated lymphocytes in a previous analysis. Associations between FDR and long-term prevalence of toxicity were assessed using univariable logistic regression analyses. The 101 participants had a median follow-up period of 9 years. Outcomes were discordant in 71% of symptomatic patients; in 21%, the physician-assessed toxicity (using CTCAE) was higher, and, in 50%, the patients reported higher toxicity. We did not find a correlation between presence of toxicity at long-term follow-up and FDR. In conclusion, patients assigned greater severity to symptoms than the trial physician assistant did. Consideration of both perspectives may be warranted to provide the best care.
KW - external beam radiotherapy
KW - gamma-H2AX assay
KW - late radiation toxicity
KW - patient-reported outcome measures
KW - prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=85127033226&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers14071670
DO - https://doi.org/10.3390/cancers14071670
M3 - Article
C2 - 35406443
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 7
M1 - 1670
ER -