Comprehensive geriatric assessment predicts radiation-induced acute toxicity in prostate cancer patients.

Abstract

The purpose of the present prospective study was to evaluate the significance of geriatric conditions measured by acomprehensive geriatric assessment (GA) for the prediction of the risk of high-grade acute radiation-induced toxicity. Atotal of 314 prostate cancer patients (age ≥ 65years) undergoing definitive radiotherapy at atertiary academic center were included. Prior to treatment, patients underwent aGA. High-grade toxicity was defined as acute toxicity grade ≥ 2 according to standard RTOG/EORTC criteria. To analyze the predictive value of the GA, univariable and multivariable logistic regression models were applied. A total of 40 patients (12.7%) developed acute toxicity grade ≥ 2; high grade genitourinary was found in 37patients (11.8%) and rectal toxicity in 8patients (2.5%), respectively. Multivariable analysis revealed asignificant association of comorbidities with overall toxicity grade ≥ 2 (odds ratio [OR] 2.633, 95% confidence interval [CI] 1.260-5.502; p = 0.010) as well as with high-grade genitourinary and rectal toxicity (OR 2.169, 95%CI1.017-4.625; p = 0.045 and OR 7.220, 95%CI 1.227-42.473; p = 0.029, respectively). Furthermore, the Activities of Daily Living score (OR 0.054, 95%CI 0.004-0.651; p = 0.022), social status (OR 0.159, 95%CI 0.028-0.891; p = 0.036), and polypharmacy (OR 4.618, 95%CI 1.045-20.405; p = 0.044) were identified as independent predictors of rectal toxicity grade ≥ 2. Geriatric conditions seem to be predictive of the development of high-grade radiation-induced toxicity in prostate cancer patients treated with definitive radiotherapy.