Predictors of Patient-Reported Incontinence at Adjuvant/Salvage Radiotherapy after Prostatectomy: Impact of Time between Surgery and Radiotherapy.

Baseline urinary incontinence (UI) strongly modulates UI recovery after adjuvant/salvage radiotherapy (ART/SRT), inducing clinicians to postpone it "as much as possible", maximizing UI recovery but possibly reducing efficacy. This series aims to analyze the trend of UI recovery and its predictors at radiotherapy start.

A population of 408 patients treated with ART/SRT enrolled in a cohort study (ClinicalTrials.gov #NCT02803086) aimed at developing predictive models of radiation-induced toxicities. Self-reported UI and personality traits, evaluated by means of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) and Eysenck Personality Questionnaire - Revised (EPQ-R) questionnaires, were assessed at ART/SRT start. Several endpoints based on baseline ICIQ-SF were investigated: frequency and amount of urine loss (ICIQ3 and ICIQ4, respectively), "objective" UI (ICIQ3 + 4), "subjective" UI (ICIQ5), and "TOTAL" UI (ICIQ3 +4 + 5). The relationship between each endpoint and time from prostatectomy to radiotherapy (TTRT) was investigated. The association between clinical and personality variables and each endpoint was tested by uni- and multivariable logistic regression.

TTRT was the strongest predictor for all endpoints (p-values ≤ 0.001); all scores improved between 4 and 8 months after prostatectomy, without any additional long-term recovery. Neuroticism independently predicted subjective UI, TOTAL UI, and daily frequency.

Early UI recovery mostly depends on TTRT with no further improvement after 8 months from prostatectomy. Higher levels of neuroticism may overestimate UI.

Cancers. 2021 Jun 29*** epublish ***

Fernando Munoz, Giuseppe Sanguineti, Andrea Bresolin, Domenico Cante, Vittorio Vavassori, Justina Magdalena Waskiewicz, Giuseppe Girelli, Barbara Avuzzi, Elisabetta Garibaldi, Adriana Faiella, Elisa Villa, Alessandro Magli, Barbara Noris Chiorda, Marco Gatti, Tiziana Rancati, Riccardo Valdagni, Nadia G Di Muzio, Claudio Fiorino, Cesare Cozzarini

SC Radioterapia Oncologica, Ospedale Regionale Parini-AUSL Valle d'Aosta, 11100 Aosta, Italy., Deptartment of Radiotherapy, IRCCS Istituto Nazionale dei Tumori "Regina Elena", 00144 Roma, Italy., Deptartment of Medical Physics and Deptartment of Radiotherapy, IRCCS Istituto Scientifico Ospedale San Raffaele, 20132 Milano, Italy., Deptartment of Radiotherapy, ASL TO4, Ospedale di Ivrea, 10015 Ivrea, Italy., Deptartment of Radiotherapy, Cliniche Gavazzeni-Humanitas, 24125 Bergamo, Italy., Deptartment of Radiotherapy, Azienda Sanitaria dell'Alto Adige, 39100 Bolzano, Italy., Deptartment of Radiotherapy, Ospedale degli Infermi, 22399 Biella, Italy., Deptartment of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy., SC Radioterapia, AO SS Antonio e Biagio e Cesare Arrigo Alessandria, 15121 Alessandria, Italy., Deptartment of Radiotherapy, Azienda Ospedaliero Universitaria S. Maria della Misericordia, 33100 Udine, Italy., Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia IRCCS, Candiolo, 10060 Torino, Italy.

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