Obesity and Acute Urinary and Bowel Quality of Life (QOL) during Prostate Radiation Therapy

Abstract

Obesity has been associated with increased risk of complications for men undergoing radical prostatectomy; however, the impact of obesity on toxicity and QOL with external beam radiotherapy (RT) is unclear. We examined acute changes in urinary and bowel QOL among obese men compared to non-obese men receiving RT for prostate cancer. All patients receiving definitive RT (>70 Gy) for intact prostate cancer at a single institution from 2010 to 2016 prospectively completed QOL surveys using the validated Prostate Cancer Symptom Index (PCSI) at baseline and weekly during treatment. Urinary Obstructive/Irritative and Bowel domains scores were calculated, ranging from 0 (best QOL) to 100 (worst). QOL scores were compared among patients who were non-obese (body mass index <30) vs obese (body mass index≥30) using parametric statistical tests. We further compared each individual urinary and bowel item among obese and non-obese patients, and a worsening of ≥2 points on a 4-5 point Likert scale in any item during RT was defined as a clinically meaningful change in the PCSI. Logistic regression assessed whether obesity was associated with clinically significant worsening of specific symptoms, adjusting for age, baseline symptoms, and androgen deprivation therapy use. Two hundred eleven patients were included and 39% were obese; 90% received concurrent androgen deprivation therapy. At baseline, overall bowel and urinary domain scores were not significantly different among obese and non-obese patients. Bowel and urinary scores worsened from baseline to end of RT for both obese and non-obese patients. On multivariable analysis, obesity was not significantly associated with worsening of any individual urinary or bowel symptom. Our results showed no evidence that obesity increased acute patient-reported urinary or bowel QOL changes overall, or for any individual symptom, during RT. These findings help inform patients and physicians during the treatment decision-making process.Tabled 1Abstract TU_42_3734; Table 1BaselineWeek 1-2Week 3-4Week 5-6Week 7-9Bowel scoreNon-obese4.65.56.88.110.1Obese6.66.710.58.99.5Difference2.01.23.70.8-0.6Urinary scoreNon-obese24.128.221.337.737.8Obese27.129.525.637.539.4Difference3.01.34.3-0.21.6 Open table in a new tab