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Older age, early symptoms and physical function are associated with the severity of late symptom clusters for men undergoing radiotherapy for prostate cancer

Lemanska, Agnieszka, Dearnaley, David, Sydes, Matthew R and Faithfull, Sara (2018) Older age, early symptoms and physical function are associated with the severity of late symptom clusters for men undergoing radiotherapy for prostate cancer Clinical Oncology.

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Older age, early symptoms and physical function are associated with the severity of late symptom clusters for men undergoing radiotherapy for prostate cancer.docx - Accepted version Manuscript
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Abstract

Purpose: To identify symptom clusters and predisposing factors associated with long-term symptoms and health-related quality of life (HRQOL) following radiotherapy in men with prostate cancer. Methods: Patient-reported outcomes (PROs) data from the Medical Research Council RT01 radiotherapy with neoadjuvant androgen deprivation therapy (ADT) trial of 843 patients were used. PROs were collected over 5 years with the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) and the 36-Item Short-Form Health Survey (SF-36). Symptom clusters were explored using hierarchical cluster analysis (HCA). The association of treatment dose, baseline patient characteristics and early symptom clusters with the change in severity of PROs over three years was investigated with multivariate linear mixed effects models. Results: Seven symptom clusters of three or more symptoms were identified. The clusters were stable over time. The longitudinal profiles of symptom clusters showed the onset of acute symptoms during treatment for all symptom clusters and significant recovery by six months. Some clusters such as Physical Health and Sexual Function were adversely affected more than others by ADT, and were less likely to return to pre-treatment levels over time. Older age was significantly associated with decreased long-term Physical Function, Physical Health and Sexual Function (p<0.001). Both baseline and acute symptom clusters were significant antecedents for impaired function and HRQOL at three years. Conclusions: Men with poorer physical function and health prior to or during treatment were more likely to report poorer PROs at year three. Early assessment using PROs and lifestyle interventions should be employed to identify those with higher needs and provide targeted rehabilitation and symptom management.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Lemanska, Agnieszkaa.lemanska@surrey.ac.uk
Dearnaley, David
Sydes, Matthew R
Faithfull, SaraS.Faithfull@surrey.ac.uk
Date : 17 February 2018
Funders : Medical Research Council (MRC)
Identification Number : 10.1016/j.clon.2018.01.016
Copyright Disclaimer : © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Uncontrolled Keywords : Symptom clusters; Prostate cancer; Acute symptoms; Late symptoms; PROs; Radiotherapy; Survivorship
Depositing User : Clive Harris
Date Deposited : 07 Feb 2018 11:19
Last Modified : 13 Mar 2018 15:53
URI: http://epubs.surrey.ac.uk/id/eprint/845764

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