Age and Comorbid Illness Are Associated With Late Rectal Toxicity Following Dose-Escalated Radiation Therapy for Prostate Cancer
Purpose To assess the impacts of patient age and comorbid illness on rectal toxicity following external beam radiation therapy (EBRT) for prostate cancer and to assess the Qualitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) normal tissue complication probability (NTCP) model in thi...
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creator | Hamstra, Daniel A., MD, PhD Stenmark, Matt H., MD Ritter, Tim, PhD Litzenberg, Dale, PhD Jackson, William, BS Johnson, Skyler, BS Albrecht-Unger, Liesel, BS Donaghy, Alex, BS Phelps, Laura, BS Blas, Kevin, MD Halverson, Schuyler, BS Marsh, Robin, CMD Olson, Karin, PhD Feng, Felix Y., MD |
description | Purpose To assess the impacts of patient age and comorbid illness on rectal toxicity following external beam radiation therapy (EBRT) for prostate cancer and to assess the Qualitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) normal tissue complication probability (NTCP) model in this context. Methods and Materials Rectal toxicity was analyzed in 718 men previously treated for prostate cancer with EBRT (≥75 Gy). Comorbid illness was scored using the Charlson Comorbidity Index (CCMI), and the NTCP was evaluated with the QUANTEC model. The influence of clinical and treatment-related parameters on rectal toxicity was assessed by Kaplan-Meier and Cox proportional hazards models. Results The cumulative incidence of rectal toxicity grade ≥2 was 9.5% and 11.6% at 3 and 5 years and 3.3% and 3.9% at 3 and 5 years for grade ≥3 toxicity, respectively. Each year of age predicted an increasing relative risk of grade ≥2 ( P |
doi_str_mv | 10.1016/j.ijrobp.2012.10.042 |
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fullrecord | <record><control><sourceid>elsevier_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22224411</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S036030161203742X</els_id><sourcerecordid>S036030161203742X</sourcerecordid><originalsourceid>FETCH-LOGICAL-c445t-fbd5e2174e991802a45ba43bcea2c37c064f1b8a21c88837d9bbaf0e05fbf4393</originalsourceid><addsrcrecordid>eNqFkUtvEzEUhS0EoqHwDxCyxHqCX_PaIEWhpZUigdogurP8uNN4mNiRPQWy60_Hw7Qs2NQbW1fn3HvuZ4TeUrKkhFYf-qXrY9CHJSOU5dKSCPYMLWhTtwUvy5vnaEF4RQqexSfoVUo9IYTSWrxEJ4yzqiyreoHuV7eAlbd4HfYhamfx5TB4SAmvIuBVSsE4NYLF3924w5v8xFdgRjXgbfjtjBuP-DwMQ_jl_C3-FBIUZ8mo4a_lStnsdcHj7Q6iOhxxFyL-GkMapz5r5Q3E1-hFp4YEbx7uU_Tt_Gy7vig2Xz5frlebwghRjkWnbQksp4e2pQ1hSpRaCa4NKGZ4bUglOqobxahpmobXttVadQRI2elO8Jafovdz3zzdyZSTg9mZ4H3eRrJ8hKA0q8SsMjllitDJQ3R7FY-SEjlhl72cscsJ-1TN2LPt3Ww73Ok92H-mR85Z8HEWQF7xp4M4JYC8v3VxCmCDe2rC_w3M4LzLqH_AEVIf7qLP-CSViUkir6evn36eMsJrwW74Hz9Wq28</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Age and Comorbid Illness Are Associated With Late Rectal Toxicity Following Dose-Escalated Radiation Therapy for Prostate Cancer</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Hamstra, Daniel A., MD, PhD ; Stenmark, Matt H., MD ; Ritter, Tim, PhD ; Litzenberg, Dale, PhD ; Jackson, William, BS ; Johnson, Skyler, BS ; Albrecht-Unger, Liesel, BS ; Donaghy, Alex, BS ; Phelps, Laura, BS ; Blas, Kevin, MD ; Halverson, Schuyler, BS ; Marsh, Robin, CMD ; Olson, Karin, PhD ; Feng, Felix Y., MD</creator><creatorcontrib>Hamstra, Daniel A., MD, PhD ; Stenmark, Matt H., MD ; Ritter, Tim, PhD ; Litzenberg, Dale, PhD ; Jackson, William, BS ; Johnson, Skyler, BS ; Albrecht-Unger, Liesel, BS ; Donaghy, Alex, BS ; Phelps, Laura, BS ; Blas, Kevin, MD ; Halverson, Schuyler, BS ; Marsh, Robin, CMD ; Olson, Karin, PhD ; Feng, Felix Y., MD</creatorcontrib><description><![CDATA[Purpose To assess the impacts of patient age and comorbid illness on rectal toxicity following external beam radiation therapy (EBRT) for prostate cancer and to assess the Qualitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) normal tissue complication probability (NTCP) model in this context. Methods and Materials Rectal toxicity was analyzed in 718 men previously treated for prostate cancer with EBRT (≥75 Gy). Comorbid illness was scored using the Charlson Comorbidity Index (CCMI), and the NTCP was evaluated with the QUANTEC model. The influence of clinical and treatment-related parameters on rectal toxicity was assessed by Kaplan-Meier and Cox proportional hazards models. Results The cumulative incidence of rectal toxicity grade ≥2 was 9.5% and 11.6% at 3 and 5 years and 3.3% and 3.9% at 3 and 5 years for grade ≥3 toxicity, respectively. Each year of age predicted an increasing relative risk of grade ≥2 ( P <.03; hazard ratio [HR], 1.04 [95% confidence interval {CI}, 1.01-1.06]) and ≥3 rectal toxicity ( P <.0001; HR, 1.14 [95% CI,1.07-1.22]). Increasing CCMI predicted rectal toxicity where a history of either myocardial infarction (MI) ( P <.0001; HR, 5.1 [95% CI, 1.9-13.7]) or congestive heart failure (CHF) ( P <.0006; HR, 5.4 [95% CI, 0.6-47.5]) predicted grade ≥3 rectal toxicity, with lesser correlation with grade ≥2 toxicity ( P <.02 for MI, and P <.09 for CHF). An age comorbidity model to predict rectal toxicity was developed and confirmed in a validation cohort. The use of anticoagulants increased toxicity independent of age and comorbidity. NTCP was prognostic for grade ≥3 ( P =.015) but not grade ≥2 ( P =.49) toxicity. On multivariate analysis, age, MI, CHF, and an NTCP >20% all correlated with late rectal toxicity. Conclusions Patient age and a history of MI or CHF significantly impact rectal toxicity following EBRT for the treatment of prostate cancer, even after controlling for NTCP.]]></description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2012.10.042</identifier><identifier>PMID: 23265567</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; ANIMAL TISSUES ; ANTICOAGULANTS ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Comorbidity ; EXTERNAL BEAM RADIATION THERAPY ; HEALTH HAZARDS ; HEART FAILURE ; Heart Failure - epidemiology ; Hematology, Oncology and Palliative Medicine ; Humans ; Incidence ; Male ; Middle Aged ; Models, Statistical ; MULTIVARIATE ANALYSIS ; MYOCARDIAL INFARCTION ; Myocardial Infarction - epidemiology ; NEOPLASMS ; Organs at Risk - radiation effects ; PATIENTS ; PROSTATE ; Prostatic Neoplasms - epidemiology ; Prostatic Neoplasms - radiotherapy ; RADIATION DOSES ; Radiation Injuries - epidemiology ; Radiation Injuries - pathology ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiotherapy Dosage ; Radiotherapy, Image-Guided ; Radiotherapy, Intensity-Modulated ; RECTUM ; Rectum - radiation effects ; Time Factors ; TOXICITY</subject><ispartof>International journal of radiation oncology, biology, physics, 2013-04, Vol.85 (5), p.1246-1253</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-fbd5e2174e991802a45ba43bcea2c37c064f1b8a21c88837d9bbaf0e05fbf4393</citedby><cites>FETCH-LOGICAL-c445t-fbd5e2174e991802a45ba43bcea2c37c064f1b8a21c88837d9bbaf0e05fbf4393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2012.10.042$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23265567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22224411$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Hamstra, Daniel A., MD, PhD</creatorcontrib><creatorcontrib>Stenmark, Matt H., MD</creatorcontrib><creatorcontrib>Ritter, Tim, PhD</creatorcontrib><creatorcontrib>Litzenberg, Dale, PhD</creatorcontrib><creatorcontrib>Jackson, William, BS</creatorcontrib><creatorcontrib>Johnson, Skyler, BS</creatorcontrib><creatorcontrib>Albrecht-Unger, Liesel, BS</creatorcontrib><creatorcontrib>Donaghy, Alex, BS</creatorcontrib><creatorcontrib>Phelps, Laura, BS</creatorcontrib><creatorcontrib>Blas, Kevin, MD</creatorcontrib><creatorcontrib>Halverson, Schuyler, BS</creatorcontrib><creatorcontrib>Marsh, Robin, CMD</creatorcontrib><creatorcontrib>Olson, Karin, PhD</creatorcontrib><creatorcontrib>Feng, Felix Y., MD</creatorcontrib><title>Age and Comorbid Illness Are Associated With Late Rectal Toxicity Following Dose-Escalated Radiation Therapy for Prostate Cancer</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description><![CDATA[Purpose To assess the impacts of patient age and comorbid illness on rectal toxicity following external beam radiation therapy (EBRT) for prostate cancer and to assess the Qualitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) normal tissue complication probability (NTCP) model in this context. Methods and Materials Rectal toxicity was analyzed in 718 men previously treated for prostate cancer with EBRT (≥75 Gy). Comorbid illness was scored using the Charlson Comorbidity Index (CCMI), and the NTCP was evaluated with the QUANTEC model. The influence of clinical and treatment-related parameters on rectal toxicity was assessed by Kaplan-Meier and Cox proportional hazards models. Results The cumulative incidence of rectal toxicity grade ≥2 was 9.5% and 11.6% at 3 and 5 years and 3.3% and 3.9% at 3 and 5 years for grade ≥3 toxicity, respectively. Each year of age predicted an increasing relative risk of grade ≥2 ( P <.03; hazard ratio [HR], 1.04 [95% confidence interval {CI}, 1.01-1.06]) and ≥3 rectal toxicity ( P <.0001; HR, 1.14 [95% CI,1.07-1.22]). Increasing CCMI predicted rectal toxicity where a history of either myocardial infarction (MI) ( P <.0001; HR, 5.1 [95% CI, 1.9-13.7]) or congestive heart failure (CHF) ( P <.0006; HR, 5.4 [95% CI, 0.6-47.5]) predicted grade ≥3 rectal toxicity, with lesser correlation with grade ≥2 toxicity ( P <.02 for MI, and P <.09 for CHF). An age comorbidity model to predict rectal toxicity was developed and confirmed in a validation cohort. The use of anticoagulants increased toxicity independent of age and comorbidity. NTCP was prognostic for grade ≥3 ( P =.015) but not grade ≥2 ( P =.49) toxicity. On multivariate analysis, age, MI, CHF, and an NTCP >20% all correlated with late rectal toxicity. Conclusions Patient age and a history of MI or CHF significantly impact rectal toxicity following EBRT for the treatment of prostate cancer, even after controlling for NTCP.]]></description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>ANIMAL TISSUES</subject><subject>ANTICOAGULANTS</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Comorbidity</subject><subject>EXTERNAL BEAM RADIATION THERAPY</subject><subject>HEALTH HAZARDS</subject><subject>HEART FAILURE</subject><subject>Heart Failure - epidemiology</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Statistical</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>MYOCARDIAL INFARCTION</subject><subject>Myocardial Infarction - epidemiology</subject><subject>NEOPLASMS</subject><subject>Organs at Risk - radiation effects</subject><subject>PATIENTS</subject><subject>PROSTATE</subject><subject>Prostatic Neoplasms - epidemiology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>RADIATION DOSES</subject><subject>Radiation Injuries - epidemiology</subject><subject>Radiation Injuries - pathology</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Image-Guided</subject><subject>Radiotherapy, Intensity-Modulated</subject><subject>RECTUM</subject><subject>Rectum - radiation effects</subject><subject>Time Factors</subject><subject>TOXICITY</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtvEzEUhS0EoqHwDxCyxHqCX_PaIEWhpZUigdogurP8uNN4mNiRPQWy60_Hw7Qs2NQbW1fn3HvuZ4TeUrKkhFYf-qXrY9CHJSOU5dKSCPYMLWhTtwUvy5vnaEF4RQqexSfoVUo9IYTSWrxEJ4yzqiyreoHuV7eAlbd4HfYhamfx5TB4SAmvIuBVSsE4NYLF3924w5v8xFdgRjXgbfjtjBuP-DwMQ_jl_C3-FBIUZ8mo4a_lStnsdcHj7Q6iOhxxFyL-GkMapz5r5Q3E1-hFp4YEbx7uU_Tt_Gy7vig2Xz5frlebwghRjkWnbQksp4e2pQ1hSpRaCa4NKGZ4bUglOqobxahpmobXttVadQRI2elO8Jafovdz3zzdyZSTg9mZ4H3eRrJ8hKA0q8SsMjllitDJQ3R7FY-SEjlhl72cscsJ-1TN2LPt3Ww73Ok92H-mR85Z8HEWQF7xp4M4JYC8v3VxCmCDe2rC_w3M4LzLqH_AEVIf7qLP-CSViUkir6evn36eMsJrwW74Hz9Wq28</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Hamstra, Daniel A., MD, PhD</creator><creator>Stenmark, Matt H., MD</creator><creator>Ritter, Tim, PhD</creator><creator>Litzenberg, Dale, PhD</creator><creator>Jackson, William, BS</creator><creator>Johnson, Skyler, BS</creator><creator>Albrecht-Unger, Liesel, BS</creator><creator>Donaghy, Alex, BS</creator><creator>Phelps, Laura, BS</creator><creator>Blas, Kevin, MD</creator><creator>Halverson, Schuyler, BS</creator><creator>Marsh, Robin, CMD</creator><creator>Olson, Karin, PhD</creator><creator>Feng, Felix Y., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>OTOTI</scope></search><sort><creationdate>20130401</creationdate><title>Age and Comorbid Illness Are Associated With Late Rectal Toxicity Following Dose-Escalated Radiation Therapy for Prostate Cancer</title><author>Hamstra, Daniel A., MD, PhD ; Stenmark, Matt H., MD ; Ritter, Tim, PhD ; Litzenberg, Dale, PhD ; Jackson, William, BS ; Johnson, Skyler, BS ; Albrecht-Unger, Liesel, BS ; Donaghy, Alex, BS ; Phelps, Laura, BS ; Blas, Kevin, MD ; Halverson, Schuyler, BS ; Marsh, Robin, CMD ; Olson, Karin, PhD ; Feng, Felix Y., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-fbd5e2174e991802a45ba43bcea2c37c064f1b8a21c88837d9bbaf0e05fbf4393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>ANIMAL TISSUES</topic><topic>ANTICOAGULANTS</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Comorbidity</topic><topic>EXTERNAL BEAM RADIATION THERAPY</topic><topic>HEALTH HAZARDS</topic><topic>HEART FAILURE</topic><topic>Heart Failure - epidemiology</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Statistical</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>MYOCARDIAL INFARCTION</topic><topic>Myocardial Infarction - epidemiology</topic><topic>NEOPLASMS</topic><topic>Organs at Risk - radiation effects</topic><topic>PATIENTS</topic><topic>PROSTATE</topic><topic>Prostatic Neoplasms - epidemiology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>RADIATION DOSES</topic><topic>Radiation Injuries - epidemiology</topic><topic>Radiation Injuries - pathology</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Image-Guided</topic><topic>Radiotherapy, Intensity-Modulated</topic><topic>RECTUM</topic><topic>Rectum - radiation effects</topic><topic>Time Factors</topic><topic>TOXICITY</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hamstra, Daniel A., MD, PhD</creatorcontrib><creatorcontrib>Stenmark, Matt H., MD</creatorcontrib><creatorcontrib>Ritter, Tim, PhD</creatorcontrib><creatorcontrib>Litzenberg, Dale, PhD</creatorcontrib><creatorcontrib>Jackson, William, BS</creatorcontrib><creatorcontrib>Johnson, Skyler, BS</creatorcontrib><creatorcontrib>Albrecht-Unger, Liesel, BS</creatorcontrib><creatorcontrib>Donaghy, Alex, BS</creatorcontrib><creatorcontrib>Phelps, Laura, BS</creatorcontrib><creatorcontrib>Blas, Kevin, MD</creatorcontrib><creatorcontrib>Halverson, Schuyler, BS</creatorcontrib><creatorcontrib>Marsh, Robin, CMD</creatorcontrib><creatorcontrib>Olson, Karin, PhD</creatorcontrib><creatorcontrib>Feng, Felix Y., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hamstra, Daniel A., MD, PhD</au><au>Stenmark, Matt H., MD</au><au>Ritter, Tim, PhD</au><au>Litzenberg, Dale, PhD</au><au>Jackson, William, BS</au><au>Johnson, Skyler, BS</au><au>Albrecht-Unger, Liesel, BS</au><au>Donaghy, Alex, BS</au><au>Phelps, Laura, BS</au><au>Blas, Kevin, MD</au><au>Halverson, Schuyler, BS</au><au>Marsh, Robin, CMD</au><au>Olson, Karin, PhD</au><au>Feng, Felix Y., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age and Comorbid Illness Are Associated With Late Rectal Toxicity Following Dose-Escalated Radiation Therapy for Prostate Cancer</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>85</volume><issue>5</issue><spage>1246</spage><epage>1253</epage><pages>1246-1253</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract><![CDATA[Purpose To assess the impacts of patient age and comorbid illness on rectal toxicity following external beam radiation therapy (EBRT) for prostate cancer and to assess the Qualitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) normal tissue complication probability (NTCP) model in this context. Methods and Materials Rectal toxicity was analyzed in 718 men previously treated for prostate cancer with EBRT (≥75 Gy). Comorbid illness was scored using the Charlson Comorbidity Index (CCMI), and the NTCP was evaluated with the QUANTEC model. The influence of clinical and treatment-related parameters on rectal toxicity was assessed by Kaplan-Meier and Cox proportional hazards models. Results The cumulative incidence of rectal toxicity grade ≥2 was 9.5% and 11.6% at 3 and 5 years and 3.3% and 3.9% at 3 and 5 years for grade ≥3 toxicity, respectively. Each year of age predicted an increasing relative risk of grade ≥2 ( P <.03; hazard ratio [HR], 1.04 [95% confidence interval {CI}, 1.01-1.06]) and ≥3 rectal toxicity ( P <.0001; HR, 1.14 [95% CI,1.07-1.22]). Increasing CCMI predicted rectal toxicity where a history of either myocardial infarction (MI) ( P <.0001; HR, 5.1 [95% CI, 1.9-13.7]) or congestive heart failure (CHF) ( P <.0006; HR, 5.4 [95% CI, 0.6-47.5]) predicted grade ≥3 rectal toxicity, with lesser correlation with grade ≥2 toxicity ( P <.02 for MI, and P <.09 for CHF). An age comorbidity model to predict rectal toxicity was developed and confirmed in a validation cohort. The use of anticoagulants increased toxicity independent of age and comorbidity. NTCP was prognostic for grade ≥3 ( P =.015) but not grade ≥2 ( P =.49) toxicity. On multivariate analysis, age, MI, CHF, and an NTCP >20% all correlated with late rectal toxicity. Conclusions Patient age and a history of MI or CHF significantly impact rectal toxicity following EBRT for the treatment of prostate cancer, even after controlling for NTCP.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23265567</pmid><doi>10.1016/j.ijrobp.2012.10.042</doi><tpages>8</tpages></addata></record> |
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subjects | Age Factors Aged Aged, 80 and over ANIMAL TISSUES ANTICOAGULANTS Anticoagulants - administration & dosage Anticoagulants - adverse effects Comorbidity EXTERNAL BEAM RADIATION THERAPY HEALTH HAZARDS HEART FAILURE Heart Failure - epidemiology Hematology, Oncology and Palliative Medicine Humans Incidence Male Middle Aged Models, Statistical MULTIVARIATE ANALYSIS MYOCARDIAL INFARCTION Myocardial Infarction - epidemiology NEOPLASMS Organs at Risk - radiation effects PATIENTS PROSTATE Prostatic Neoplasms - epidemiology Prostatic Neoplasms - radiotherapy RADIATION DOSES Radiation Injuries - epidemiology Radiation Injuries - pathology Radiology RADIOLOGY AND NUCLEAR MEDICINE Radiotherapy Dosage Radiotherapy, Image-Guided Radiotherapy, Intensity-Modulated RECTUM Rectum - radiation effects Time Factors TOXICITY |
title | Age and Comorbid Illness Are Associated With Late Rectal Toxicity Following Dose-Escalated Radiation Therapy for Prostate Cancer |
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