ESTRO 2021 Abstract Book

S1102

ESTRO 2021

cancer D. Cante 1 , B. Avuzzi 2 , J.M. Waskiewicz 3 , A. Faiella 4 , E. Villa 5 , L. Ferella 6 , E. Garibaldi 7 , A. Magli 8 , B. Noris Chiorda 2 , G. Girelli 9 , E. Olivetta 7 , C. Piva 1 , M. Gatti 10 , P. Ferrari 3 , E. Moretti 8 , G. Sanguineti 11 , V. Vavassori 12 , F. Munoz 6 , T. Rancati 13 , F. Badenchini 13 , A. Bresolin 14 , R. Valdagni 15 , N. Di Muzio 16 , C. Fiorino 14 , C. Cozzarini 16 1 Ospedale di Ivrea, Radiotherapy, Ivrea, Italy; 2 Fondazione IRCCS Istituto Nazionale dei Tumori, Radiotherapy, Milan, Italy; 3 Azienda Sanitaria dell’Alto Adige, Radiotherapy, Bolzano, Italy; 4 IRCCS Istituto Nazionale dei Tumori “Regina Elena", Radiotherapy, Rome, Italy; 5 Cliniche Gavazzeni Humanitas , Radiotherapy, Bergamo, Italy; 6 Ospedale Regionale Parini-AUSL Valle d’Aosta, Radiotherapy, Aosta, Italy; 7 A.O. SS. Antonio e Biagio, Radiotherapy, Alessandria, Italy; 8 Azienda Ospedaliero Universitaria S. Maria della Misericordia, Radiotherapy, Udine, Italy; 9 Ospedale degli Infermi, Radiotherapy, Biella, Italy; 10 IRCC Candiolo, Radiotherapy, Candiolo, Italy; 11 RCCS Istituto Nazionale dei Tumori “Regina Elena", Radiotherapy, Rome, Italy; 12 Cliniche Gavazzeni Humanitas, Radiotherapy, Bergamo, Italy; 13 Fondazione IRCCS Istituto Nazionale dei Tumori - Prostate Program, Radiotherapy, Milan, Italy; 14 San Raffaele Scientific Institute, Medical Physics, Milan, Italy; 15 Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Program - Università degli Studi Milano, Radiotherapy, Milan, Italy; 16 San Raffaele Scientific Institute, Radiotherapy, Milan, Italy Purpose or Objective To evaluate anxiety (ANX) and depression (DEP) trends and predictors of their acute worsening during RT in men treated for prostate cancer (PCa). Materials and Methods An observational registered study aimed at creating predictive models of RT-induced toxicities and their possible impact on patient’s QoL was activated in 2014. Thus far, 660 men treated with radical, adjuvant or salvage intent (n=233, 157 and 270, respectively, have filled-in the HADS (Hospital Anxiety and Depression Score) questionnaire at baseline, RT mid-point and end (567 also at 3 months). The role of clinico-dosimetric variables (including RT intent and doses, ADT and patient personality as measured by the EPQR questionnaire) as well as that of the baseline values and worst worsening (D) between baseline and RT midpoint or end of a number of urinary symptoms (IPSS items 1-8) and incontinence (ICIQSF 3-4-5 items) and of the 10 bowel symptoms measured by the IBDQ (Inflammatory Bowel Disease Questionnaire) was evaluated. The trends over time of ANX and DEP were analyzed by means of an ANOVA test. Two end-points for univariate (UVA) logistic regression analyses were considered: the 10 th percentile of the worst D of ANX and DEP at RT mid-point/end with respect to baseline and a HADS score ≥9, indicative of clinically significant ANX and DEP, at RT end. Variables with a p-value <0.10 at UVA were entered into a multivariable regression logistic model (MVA). Results The average levels of both ANX and DEP were stable during far below the HADS threshold for clinical significance during irradiation (mean values of ANX and DEP at baseline, RT mid-point and end: 4.31 vs 4.12 vs 4.10, and 3.25 vs 3.17 vs 3.35, respectively, ANOVA p≥0.10). Of note, a statistically significant, but clinically irrelevant, improvement of the ANX mean values at 3 months as compared to baseline (3.92 vs 4.31, p=0.002) was observed, while DEPR remained stable (3.33 vs 3.37, p=0.92). The results of MVA relative to the above- mentioned endpoints are shown in the Table. A clinically significant worsening of ANX and DEP during RT with respect to the baseline was predicted by the corresponding baseline values and by the acute worsening of some intestinal symptoms (accidental soiling and nausea for ANX, abdominal pain and rectal bleeding for DEP) and urinary straining for ANX. Clinically significant ANX at RT end was predicted by baseline ANX, neuroticism, and acute worsening of urinary intermittency and urinary incontinence-related QoL, while baseline ANX and DEP levels, ageing, acute rectal bleeding and nausea independently predicted clinically significant DEP at RT end.

Conclusion Overall, ANX and DEP during and 3 months after end of RT for PCa were stable and clinically insignificant. Baseline ANX/DEP levels, neuroticism and worsening of some intestinal and urinary symptoms, but neither