Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_42_3734 - Obesity and Acute Urinary and Bowel Quality of Life (QOL) during Prostate Radiation Therapy

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Obesity and Acute Urinary and Bowel Quality of Life (QOL) during Prostate Radiation Therapy
K. A. Pearlstein1, S. Saripalli2, R. Basak3, J. K. Sun2, E. Lobos1, A. Z. Wang3, and R. C. Chen1; 1University of North Carolina Hospitals, Chapel Hill, NC, 2University of North Carolina at Chapel Hill, Chapel Hill, NC, 3The University of North Carolina at Chapel Hill, Chapel Hill, NC

Purpose/Objective(s): 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.

Materials/Methods: 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.

Results: 211 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.

Conclusion: Out 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.

 
   

Baseline

Week 1-2

Week 3-4

Week 5-6

Week 7-9

Bowel score

Non-obese

4.6

5.5

6.8

8.1

10.1

 

Obese

6.6

6.7

10.5

8.9

9.5

 

Difference

2.0

1.2

3.7

0.8

-0.6

Urinary score

Non-obese

24.1

28.2

21.3

37.7

37.8

 

Obese

27.1

29.5

25.6

37.5

39.4

 

Difference

3.0

1.3

4.3

-0.2

1.6

 

Author Disclosure: K.A. Pearlstein: Employee; UNC Hospitals. S. Saripalli: None. R. Basak: None. A.Z. Wang: Stock; Capio Biosciences. Partnership; Capio Biosciences. Patent/License Fees/Copyright; Capio Biosciences. Co-founder and board member; Capio Biosciences. R.C. Chen: Research Grant; Accuray Inc. Consultant; Accuray Inc.

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