An investigation of the risk factors associated with late toxicity after whole pelvic irradiation in patients with prostate cancer

Abstract

Author(s): Ahmed Sabah Mohammed Jamil, Hayder Hamza Alabedi, Imad Khalid Ahmed, Amina Nazar Abdulrazaq Qasim

Objectives: The research sought to determine the prevalence of patients and cancer-related risk factors associated with late toxicity. Methods: Fifteen individuals with non-metastatic prostate cancer who had radiation were included in cross-sectional research. The research was conducted at the Baghdad Radiotherapy and Nuclear Medicine Centre in the Baghdad Medical City Complex, Iraq. The study took place from December 2022 to May 2022. The data were acquired retrospectively via a thorough examination of medical records. The study examined the variables of age, residency (address), smoking habits, TNM staging, histopathology, grades, GS, initial PSA concentration, ADT, treatment modality, dose of RT, risk group, and adverse effects including diarrhoea, pain, dysuria, anaemia, retention, haematuria, lymphedema, incontinence, urgency, sexual dysfunction, PTV95%, and OAR constraints doses. Results: In this study, several adverse effects after RT were recorded. The overall mean PTV of 95% was 93.5 ± 6.57 (median=94%), ranging from 80% to 99.9%. Old age patients were significantly more suffered from diarrhoea (OR=3.33; p=0.046) and dysuria (OR=5.5; p=0.037). Stages of the tumour, either II or III/IV, were a significant risk for pain (OR= 10; p=0.015) and sexual dysfunction (OR=2; p=0.02). High PSA levels significantly enhanced dysuria development (OR=2.5; p=0.05). A high dose of RT was significantly associated with sexual dysfunction (OR=2.8; p=0.04). Extensive PTV95% coverage can affect considerably the risk of diarrhoea (OR=3.6; p=0.033), pain (OR=3.6; p=0.033) and dysuria (OR=4; p=0.023). Conclusions: As far as we know, this is the first investigation conducted in Iraq to assess the number of patients and the risk variables associated with cancer that contribute to delayed toxicity. Advanced stages, high PSA levels, high GS levels, and the presence of comorbidities characterise prostatic adenocarcinoma in Iraqi individuals. These patients are in the high-risk category because of their old age and smoking habits. Delayed GastroIntestinal (GIT) and Genito-Urinary (GUT) toxicities are anticipated to occur only with high doses of Radiation Therapy (RT). Old age, advanced stage, high PSA level, and extensive RT PTV 95% coverage considerably increase the likelihood of developing late toxicities.

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