Abstract
PurposeTo assess toxicity and quality-of-life (QOL) after carbon ion radiotherapy (CIRT) at the Shanghai Proton and Heavy Ion Center (SPHIC) and identify clinical factors that correlate with urinary, bowel and sexual function.MethodsSixty-four patients with localized prostate cancer admitted from July 2015 to January 2018 underwent CIRT. At baseline and 5 time-points after radiotherapy, we assessed patients’ QOL using the 26-item edition of the Expanded Prostate Cancer Index-Composite (EPIC-26) Chinese version. Logistic regression was performed to identify clinical factors associated with acute genitourinary (GU) toxicity and relative QOL.ResultsBy the end of CIRT, urinary irritation/obstruction temporarily declined (− 7.92 ± 1.76, p < .001). For urinary incontinence, bowel and sexual QOL, the scores remained stable at 2-year follow-up. The occurrences of acute Grade 1 and 2 GU toxicity were 20.3 and 10.9%, respectively, and of late Grade 1 and 2 GU toxicity were 3.1 and 1.6%, respectively. No acute or late gastrointestinal (GI) toxicity occurred. Transurethral resection of the prostate (TURP) was a risk factor that predicted a decline in urinary related QOL, and age made a difference to bowel-related QOL. For sexual QOL, castration status was a remarkable risk factor. An international prostate symptom score (IPSS) ≥8 increased the risk of Grade 1–2 acute GU toxicity 5.3-fold.ConclusionPatients with prostate cancer had favorable QOL after CIRT. IPSS ≥8 was a risk factor to acute GU toxicity, and TURP predicted a decline in urinary QOL. Age was related to bowel QOL, and castration status was associated with sexual QOL.Trial registrationCarbon Ion Radiotherapy for the Treatment of Localized Prostate Cancer, NCT02739659. Registered April 15, 2016.
Highlights
Prostate cancer is the most common urologic cancer among Chinese men with largest increase in incidence of all cancers in 2015 [1]
There was no significant difference in baseline characteristics between two groups
Forty-six (71.9%) men were treated with 59.2–60.8 Gray equivalent (GyE)/16 fx, whereas 18 men (28.1%) received a prescription dose of 66 GyE/24 fx
Summary
Prostate cancer is the most common urologic cancer among Chinese men with largest increase in incidence of all cancers in 2015 [1]. Some clinical trials have reported excellent disease control and favorable toxicity of CIRT for prostate cancer [5,6,7,8]. There are few studies on the quality of life (QOL) and toxicity after CIRT for prostate cancer [5, 9], and none has explored the factors associated with. Identifying the factors affecting toxicity and QOL can characterize the patients who will benefit the most from CIRT. Phase I/II clinical trials (NCT02739659) of CIRT for localized prostate cancer at the Shanghai Proton and Heavy Ion Center (SPHIC) were initiated in 2016, using the IONTRIS particle therapy system. The purpose of this article was to demonstrate the QOL change from CIRT for prostate cancer at the SPHIC and investigate the factors that affected acute toxicity and long-term QOL changes
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