2325 - Impact of Radiotherapy on Fatigue in Prostate Cancer Patients: An Analysis of 1253 Patients
Presenter(s)
P. Bonome1, M. Ferro1, S. Cilla2, M. Boccardi1, M. Ferro3, D. Pezzulla1, V. Picardi1, C. Romano2, M. Buwenge4, A. G. Morganti4,5, G. Macchia1, and F. Deodato1,6; 1Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy, 2Medical Phisics Unit, Responsible Research Hospital, Campobasso, Italy, 3Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy, Campobasso, Italy, 4Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Bologna University, Bologna, Italy, 5Radiation Oncology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy, 6Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy
Purpose/Objective(s): Fatigue is a symptom frequently related to cancer and its different treatments. The negative impact on the physical and psychological health of cancer patients is well reported. In this study, the impact of radiotherapy (RT) on the fatigue of prostate cancer (PC) patients was evaluated in a large population.
Materials/Methods: A retrospective analysis was conducted on PC patients undergoing radical treatment from December 2002 to September 2022. Data collected included patient characteristics (age, comorbidities), Androgen-Deprivation Therapy (ADT), RT dose and fractionation, and related toxicities. Fatigue levels were measured using the Cancer Linear Analogue Scale (CLAS) in three areas: quality of life (CLAS1), energy level (CLAS2), and ability to perform daily activities (CLAS3). Data were collected before RT (T0), after one month (T1), and after 12 months (T2). Two Scores (ScRT10 and ScRT20) were obtained by subtracting the CLAS values at T1 and T2 from the T0 values. A decrease of =2 points was considered clinically significant.
Results: A total of 1253 patients were evaluated, with a median age of 72 years (range 45-90). Most patients (67%) had no or one comorbidity, and 80% had an optimal performance status (ECOG 0). RT was the exclusive treatment in 61% of cases, and 84% received ADT. The majority (86%) were treated with hypo-fractionated or stereotactic RT schedules. At T1, significant fatigue onset (=2 points decrease in CLAS scores) was observed in 10.8% for CLAS1, 14.3% for CLAS2, and 14.8% for CLAS3. At T2, fatigue onset was seen in 12.7%, 18.8%, and 19.4%, respectively. Logistic regression identified several factors associated with increased fatigue at T2, including concomitant ADT, late toxicities, and alcohol consumption, particularly influencing CLAS3 (p<0.005). Acute genito-urinary toxicities were correlated with worsening fatigue in CLAS2 at T1 (p=0.016). Other clinical variables increasing RT-related fatigue are reported in Table 1.
Conclusion: In a large PC series mostly treated with modern techniques, RT-related fatigue onset was reported in <15% of patients. Treatment-related toxicities and factors unrelated to RT, such as alcohol assumption and concomitant ADT, play a significant role in fatigue onset.
Abstract 2325 - Table 1: Clinical variables increasing RT-related fatigue (logistic regression)
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||