TY  - JOUR
UR  - http://dx.doi.org/10.1016/j.clon.2018.01.016
SN  - 1433-2981
A1  - Lemanska, A
A1  - Dearnaley, DP
A1  - Jena, R
A1  - Sydes, MR
A1  - Faithfull, S
JF  - Clinical Oncology
VL  - 30
SP  - 334
IS  - 6
N1  - © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/
licenses/by/4.0/)
PB  - ELSEVIER SCIENCE LONDON
N2  - AIMS:
To identify symptom clusters and predisposing factors associated with long-term symptoms and health-related quality of life after radiotherapy in men with prostate cancer.

MATERIALS AND METHODS:
Patient-reported outcomes (PROs) data from the Medical Research Council RT01 radiotherapy with neoadjuvant androgen deprivation therapy 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. The association of treatment dose, baseline patient characteristics and early symptom clusters with the change in severity of PROs over 3 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 6 months. Some clusters, such as physical health and sexual function, were adversely affected more than others by androgen deprivation therapy, and were less likely to return to pretreatment 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 health-related quality of life at 3 years.

CONCLUSIONS:
Men with poorer physical function and health before or during treatment were more likely to report poorer PROs at year 3. Early assessment using PROs and lifestyle interventions should be used to identify those with higher needs and provide targeted rehabilitation and symptom management.
ID  - discovery10043650
KW  - Science & Technology
KW  -  Life Sciences & Biomedicine
KW  -  Oncology
KW  -  Acute symptoms
KW  -  late symptoms
KW  -  PROs
KW  -  prostate cancer
KW  -  radiotherapy
KW  -  survivorship
KW  -  symptom clusters
KW  -  QUALITY-OF-LIFE
KW  -  DOSE CONFORMAL RADIOTHERAPY
KW  -  RANDOMIZED CONTROLLED-TRIAL
KW  -  ANDROGEN DEPRIVATION
KW  -  RADIATION-THERAPY
KW  -  HEALTH OUTCOMES
KW  -  UNITED-KINGDOM
KW  -  BREAST-CANCER
KW  -  LUNG-CANCER
KW  -  MANAGEMENT
AV  - public
Y1  - 2018/06//
EP  - 345
TI  - Older Age, Early Symptoms and Physical Function are Associated with the Severity of Late Symptom Clusters for Men Undergoing Radiotherapy for Prostate Cancer
ER  -