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Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy.

Publication ,  Journal Article
Mavroidis, P; Pearlstein, KA; Dooley, J; Sun, J; Saripalli, S; Das, SK; Wang, AZ; Chen, RC
Published in: Radiat Oncol
February 2, 2018

BACKGROUND: To estimate the radiobiological parameters of three popular normal tissue complication probability (NTCP) models, which describe the dose-response relations of bladder regarding different acute urinary symptoms during post-prostatectomy radiotherapy (RT). To evaluate the goodness-of-fit and the correlation of those models with those symptoms. METHODS: Ninety-three consecutive patients treated from 2010 to 2015 with post-prostatectomy image-guided intensity modulated radiotherapy (IMRT) were included in this study. Patient-reported urinary symptoms were collected pre-RT and weekly during treatment using the validated Prostate Cancer Symptom Indices (PCSI). The assessed symptoms were flow, dysuria, urgency, incontinence, frequency and nocturia using a Likert scale of 1 to 4 or 5. For this analysis, an increase by ≥2 levels in a symptom at any time during treatment compared to baseline was considered clinically significant. The dose volume histograms of the bladder were calculated. The Lyman-Kutcher-Burman (LKB), Relative Seriality (RS) and Logit NTCP models were used to fit the clinical data. The fitting of the different models was assessed through the area under the receiver operating characteristic curve (AUC), Akaike information criterion (AIC) and Odds Ratio methods. RESULTS: For the symptoms of urinary urgency, leakage, frequency and nocturia, the derived LKB model parameters were: 1) D50 = 64.2Gy, m = 0.50, n = 1.0; 2) D50 = 95.0Gy, m = 0.45, n = 0.50; 3) D50 = 83.1Gy, m = 0.56, n = 1.00; and 4) D50 = 85.4Gy, m = 0.60, n = 1.00, respectively. The AUC values for those symptoms were 0.66, 0.58, 0.64 and 0.64, respectively. The differences in AIC between the different models were less than 2 and ranged within 0.1 and 1.3. CONCLUSIONS: Different dose metrics were correlated with the symptoms of urgency, incontinence, frequency and nocturia. The symptoms of urinary flow and dysuria were poorly associated with dose. The values of the parameters of three NTCP models were determined for bladder regarding four acute urinary symptoms. All the models could fit the clinical data equally well. The NTCP predictions of urgency showed the best correlation with the patient reported outcomes.

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Published In

Radiat Oncol

DOI

EISSN

1748-717X

Publication Date

February 2, 2018

Volume

13

Issue

1

Start / End Page

17

Location

England

Related Subject Headings

  • Urination Disorders
  • Urinary Bladder
  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiobiology
  • Radiation Injuries
  • Prostatic Neoplasms
  • Prostatectomy
 

Citation

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Mavroidis, P., Pearlstein, K. A., Dooley, J., Sun, J., Saripalli, S., Das, S. K., … Chen, R. C. (2018). Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy. Radiat Oncol, 13(1), 17. https://doi.org/10.1186/s13014-018-0961-x
Mavroidis, Panayiotis, Kevin A. Pearlstein, John Dooley, Jasmine Sun, Srinivas Saripalli, Shiva K. Das, Andrew Z. Wang, and Ronald C. Chen. “Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy.Radiat Oncol 13, no. 1 (February 2, 2018): 17. https://doi.org/10.1186/s13014-018-0961-x.
Mavroidis P, Pearlstein KA, Dooley J, Sun J, Saripalli S, Das SK, et al. Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy. Radiat Oncol. 2018 Feb 2;13(1):17.
Mavroidis, Panayiotis, et al. “Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy.Radiat Oncol, vol. 13, no. 1, Feb. 2018, p. 17. Pubmed, doi:10.1186/s13014-018-0961-x.
Mavroidis P, Pearlstein KA, Dooley J, Sun J, Saripalli S, Das SK, Wang AZ, Chen RC. Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy. Radiat Oncol. 2018 Feb 2;13(1):17.
Journal cover image

Published In

Radiat Oncol

DOI

EISSN

1748-717X

Publication Date

February 2, 2018

Volume

13

Issue

1

Start / End Page

17

Location

England

Related Subject Headings

  • Urination Disorders
  • Urinary Bladder
  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiobiology
  • Radiation Injuries
  • Prostatic Neoplasms
  • Prostatectomy