Comprehensive understanding of the late treatment-related toxicities is important in guiding treatment decision-making for men with localized prostate cancer, since these men often survive for many years post-treatment. Prevalence and incidence are commonly used to report late treatment-related toxicities. However, these 'traditional' toxicity reporting may be misleading, given that some of the treatment-related toxicities may not be long-lasting or persistent.
Late, persistent, substantial treatment-related symptoms (LAPERS) is a novel methodological approach to report on clinically relevant and long-lasting symptoms after treatment. The concept of LAPERS...
Methods and materials
Study population:The study comprised men with low to intermediate risk prostate cancer, who had LDR-BT in a single Australia institution. As part of standard of care in our deparment, all men completed the Expanded Prostate Cancer Index Composite short form (EPIC-26) prior to treatment, and at regular intervals post treatment (at 3- and 6-month post-treatment, then 6-monthly for 2 years, and annually thereafter to 10 years).Only men who had EPIC-26 data at baseline and at least three follow-up timepoint (at least 6 months) post LDR-BT...
177 men were included in this study. Median follow-up was 60 months (IQR: 36-74 months).
For overall urinary function, proportion of men with LAPERS was 2.3% (4/177), and baseline adjusted LAPERS was 2.3% (4/177). The prevalence of substantial urinary symptoms at 24 months and 60 months were 4.4% (5/170) and 1.8% (1/91) respectively (Figure 1). The 5-year cumulative incidence of substantial urinary symptoms was 17.8% (95%CI=12.7-24.6).
For overall bowel function, proportion of men with LAPERS was 2.3% (4/177), and...
This is the first replication study of LAPERS methodology in reporting of long-term patient-reported toxicities in a prostate cancer cohort. We observed considerable differences between LAPERS, prevalence at specified time-point, and cumulative incidence of ’substantial’ symptoms in men with prostate cancer treated with LDR-BT
1. LAPERS is more reflective of ‘true’ late toxicities, considering duration and persistence of symptoms, and should be considered as part of standard reporting for late treatment-related toxicities.
2. Prevalence at specified time-point does not account for changing denominator (e.g., patients...
Kirchheiner K, Potter R, Nout RA, Schwartz-Vittrup A, Holzner B, Bentzen SM, et al. Late, Persistent, Substantial, Treatment-Related Symptoms After Radiation Therapy (LAPERS): A New Method for Longitudinal Analysis of Late Morbidity-Applied in the EMBRACE Study. Int J Radiat Oncol Biop Phys. 2020;106(2):300-9.