title: The ADAPP trial: a two-year longitudinal multidisciplinary intervention study for prostate cancer frail patients on androgen deprivation associated to curative radiotherapy.
abstract: BACKGROUND
  Androgen deprivation (AD) therapy combined to radiotherapy (RT) is a curative therapeutic option for patients with non-metastatic locally advanced or aggressive intermediate prostate cancer (PC), though with a range of nutritional, physical, and psychological side effects. A multidisciplinary care program was created to help frail patients to prevent and manage those side effects.
  
  
  METHODS
  We conducted a longitudinal interventional study in frail patients, presenting either cardiovascular/pulmonary comorbidities, old age (≥75 years), vulnerability ratings, or balance impairment. Patients were treated by AD and RT and, benefited from nutritional coaching, supervised biweekly 45 minute physical training, and psychological counseling for two years. Treatment outcomes included PC-related quality of life (QoL), body mass index, fat mass index, and fat-free mass index derived from bioelectrical impedance analysis, Six-Minute Walk Test, Timed Up&Go, handgrip strength, Hospital Anxiety and Depression scale, Mini Mental State Examination. Measures were repeated after zero, three, six, nine, 12, 18, 24 months, and 12-months post-study follow-up. A prospective mixed-model design was used to assess longitudinal outcome.
  
  
  RESULTS
  Regression analyses revealed no significant change over the two years, including post-study follow-up. Means of QoL, nutritional, physical, as well as psychological variables remained stable over more than two years in the 35 men aged 74 (range 68-76) years.
  
  
  CONCLUSIONS
  The expected side effects of AD and RT were not observed in frail PC patients who followed this multidisciplinary care program.
authors.affiliation: a Clinical Nutrition, Department of Internal Medicine Specialities , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Julie
authors.initials: J
authors.lastname: Mareschal
authors.affiliation: b Liaison Psychiatry and Crisis Intervention, Department of Mental Health and Psychiatry , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Weber
authors.affiliation: a Clinical Nutrition, Department of Internal Medicine Specialities , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Pascale
authors.initials: P
authors.lastname: Rigoli
authors.affiliation: c Physical Medicine and Orthopaedics Rehabilitation, Department of Surgery , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Edmund
authors.initials: E
authors.lastname: Biason
authors.affiliation: b Liaison Psychiatry and Crisis Intervention, Department of Mental Health and Psychiatry , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Laura
authors.initials: L
authors.lastname: Frambati
authors.affiliation: d Radiation Oncology, Department of Oncology , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Carole
authors.initials: C
authors.lastname: Gotteland
authors.affiliation: d Radiation Oncology, Department of Oncology , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zilli
authors.affiliation: a Clinical Nutrition, Department of Internal Medicine Specialities , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
authors.affiliation: d Radiation Oncology, Department of Oncology , Geneva University Hospital , Geneva , Switzerland.
authors.forename: Raymond
authors.initials: R
authors.lastname: Miralbell
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003376:Counseling; D016330:Frail Elderly; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011471:Prostatic Neoplasms / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy*; D011613:Psychotherapy; D011788:Quality of Life
chemical_list: D000726:Androgen Antagonists