title: Prospective assessment of urinary, gastrointestinal and sexual symptoms before, during and after image-guided volumetric modulated arc therapy for prostate cancer.
abstract: OBJECTIVE
  The aim of this study was to prospectively assess the development of 24 urinary, gastrointestinal and sexual symptoms in patients with prostate cancer (PCa) during and after image-guided volumetric modulated arc therapy (IG-VMAT).
  
  
  METHODS
  A total of 87 patients with PCa participated in this study. The patients were asked to complete a modified version of the Prostate Cancer Symptom Scale (PCSS) questionnaire before radiotherapy (RT) (baseline), at the start of RT, at the end of RT and 1 year after RT. Changes in symptoms at the start of RT, at the end of RT and 1 year after RT compared to baseline were analysed by a mixed model analysis of repeated measurements with the following covariates: age, comorbidity, smoking and androgen deprivation therapy (ADT).
  
  
  RESULTS
  All urinary problems except for haematuria increased significantly at the end of RT compared to baseline. One year after RT, there was no longer any difference compared to baseline for any of the urinary symptoms. All gastrointestinal symptoms except for nausea increased significantly at the end of RT. One year after RT, patients also reported slightly higher degrees of stool frequency, bowel leakage, planning of toilet visits, flatulence, mucus, gastrointestinal bleeding and impact of gastrointestinal bother on daily activities compared to baseline. All sexual symptoms increased significantly at all times compared to baseline. The use of ADT was associated with worse sexual symptoms.
  
  
  CONCLUSIONS
  IG-VMAT is a safe treatment for PCa, with few and mild changes in urinary and gastrointestinal symptoms 1 year after RT compared to baseline. Sexual symptoms deteriorated both during and after RT. The use of ADT was associated with worse sexual symptoms.
authors.affiliation: Departments of Radiation Oncology.
authors.forename: Joen
authors.initials: J
authors.lastname: Sveistrup
authors.forename: Anders
authors.initials: A
authors.lastname: Widmark
authors.forename: Per
authors.initials: P
authors.lastname: Fransson
authors.forename: Peter
authors.initials: P
authors.lastname: Iversen
authors.forename: Per
authors.initials: P
authors.lastname: Munck Af Rosenschöld
authors.forename: Svend Aage
authors.initials: SA
authors.lastname: Engelholm
authors.forename: Peter Meidahl
authors.initials: PM
authors.lastname: Petersen
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D059248:Chemoradiotherapy; D015331:Cohort Studies; D053159:Dysuria / Q000209:etiology*; D005767:Gastrointestinal Diseases / Q000209:etiology*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology*; D020360:Neoadjuvant Therapy; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires
chemical_list: D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone
keywords: prostate cancer; questionnaire; radiotherapy; self-assessment; toxicity