- Title
- Urinary symptoms following external beam radiotherapy of the prostate: Dose-symptom correlates with multiple-event and event-count models
- Creator
- Yahya, Noorazrul; Ebert, Martin A.; Bulsara, Max; House, Michael J.; Kennedy, Angel; Joseph, David J.; Denham, James W.
- Relation
- NHMRC.300705, NHMRC.455521 & NHMRC.1006447
- Relation
- Radiotherapy and Oncology Vol. 117, Issue 2, p. 277-282
- Publisher Link
- http://dx.doi.org/10.1016/j.radonc.2015.10.003
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2015
- Description
- 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-A75 Gy) 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-R41 Gy). 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.
- Subject
- prostate radiotherapy; normal tissue complications; urinary symptoms; multiple-event model; event-count model
- Identifier
- http://hdl.handle.net/1959.13/1313270
- Identifier
- uon:22558
- Identifier
- ISSN:0167-8140
- Language
- eng
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