title: Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial.
abstract: OBJECTIVE
  To identify dosimetry, clinical factors and medication intake impacting urinary symptoms after prostate radiotherapy.
  
  
  METHODS
  Data describing clinical factors and bladder dosimetry (reduced with principal component (PC) analysis) for 754 patients treated with external beam radiotherapy accrued by TROG 03.04 RADAR prostate radiotherapy trial were available for analysis. Urinary symptoms (frequency, incontinence, dysuria and haematuria) were prospectively assessed using LENT-SOMA to a median of 72months. The endpoints assessed were prevalence (grade ⩾1) at the end of radiotherapy (representing acute symptoms), at 18-, 36- and 54-month follow-ups (representing late symptoms) and peak late incidence including only grade ⩾2. Impact of factors was assessed using multivariate logistic regression models with correction for over-optimism.
  
  
  RESULTS
  Baseline symptoms, non-insulin dependent diabetes mellitus, age and PC1 (correlated to the mean dose) impact symptoms at >1 timepoints. Associations at a single timepoint were found for cerebrovascular condition, ECOG status and non-steroidal anti-inflammatory drug intake. Peak incidence analysis shows the impact of baseline, bowel and cerebrovascular condition and smoking status.
  
  
  CONCLUSIONS
  The prevalence and incidence analysis provide a complementary view for urinary symptom prediction. Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact.
authors.affiliation: School of Physics, University of Western Australia, Australia; Faculty of Health Sciences, National University of Malaysia, Bangi, Malaysia. Electronic address: noorazrul.yahya@research.uwa.edu.au.
authors.forename: Noorazrul
authors.initials: N
authors.lastname: Yahya
authors.affiliation: School of Physics, University of Western Australia, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Australia.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Ebert
authors.affiliation: Institute for Health Research, University of Notre Dame, Fremantle, Australia.
authors.forename: Max
authors.initials: M
authors.lastname: Bulsara
authors.affiliation: Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia.
authors.forename: Annette
authors.initials: A
authors.lastname: Haworth
authors.affiliation: Department of Radiation Oncology, Sir Charles Gairdner Hospital, Australia.
authors.forename: Angel
authors.initials: A
authors.lastname: Kennedy
authors.affiliation: Department of Radiation Oncology, Sir Charles Gairdner Hospital, Australia; School of Surgery, University of Western Australia, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Joseph
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Australia.
authors.forename: Jim W
authors.initials: JW
authors.lastname: Denham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011874:Radiometry; D001743:Urinary Bladder; D014570:Urologic Diseases / Q000503:physiopathology*
keywords: Prostate cancer; Radiotherapy; Urinary symptoms