Effect of Kegel exercises on the prevention of urinary and fecal incontinence in patients with prostate cancer undergoing radiotherapy

2021 ◽  
Vol 51 ◽  
pp. 101913
Author(s):  
A.E. Urvaylıoğlu ◽  
S. Kutlutürkan ◽  
D. Kılıç
Keyword(s):  
Prostate Cancer ◽  
Fecal Incontinence ◽  
Kegel Exercises

A set of nomograms predicting acute gastrointestinal syndrome after prostate cancer conformal radiation

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15555-15555
Author(s):  
R. Valdagni ◽  
T. Rancati ◽  
C. Fiorino ◽  
G. Fellin ◽  
L. Vera Righi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Fecal Incontinence ◽  
Protective Factor ◽  
Drug Prescription ◽  
Continuous Variable ◽  
Seminal Vesicles ◽  
Severe Bleeding ◽  
Rectal Pain ◽  
Rectal Dose ◽  
Gi Symptoms

15555 Background: To predict acute toxicities (tox) of the gastrointestinal syndrome (SOMA LENT) in prostate cancer (PCa) patients (pts) undergoing 3D-CRT using a tool (nomogram) with clinical as well as dosimetric variables which has proved to be significant in the AIROPROS 01–02 trial. Methods: Acute rectal tox was scored in 1,132 pts using a 10 item self assessed questionnaire (QST) describing radio-induced GI symptoms profiles for bowel frequency, tenesmus, fecal continence, rectal pain and bleeding. The correlation between hormonal therapy (HT), drug prescription, diabetes or hypertension, pelvic node or seminal vesicles irradiation, mean rectal dose, DVH constraints and rectal tox was investigated by uni- and multivariate (MVA) logistic analyses. MVA results were used the R-project software to create nomograms predicting the symptoms of the acute GI syndrome. Results: 4/10 items of the QST are reported: moderate/severe bleeding, increased bowel frequency, moderate/severe bowel urgency and severe fecal incontinence. Bleeding is related to haemorrhoids (OR=1.9), HT (protective factor, OR=0.78) and mean rectal dose (continuous variable (cv), OR=1.024). Bowel frequency is related to seminal vesicles irradiation (OR=2.8) and V60 (cv, OR=1.024), while bowel urgency is correlated to seminal vesicles irradiation (OR=3.3) and mean rectal dose (cv, OR=1.027). Fecal incontinence depends on seminal vesicles irradiation (OR=4.6) and V70 (cv, OR=1.029). MVA results were used to create a set of nomograms. Conclusions: The combined effect of several independent, prognostically valuable variables for a specific disease can be expressed using nomograms. They can evaluate clinical and technical parameters of the single pt and offer clinicians a tailored probability of a specific outcome. To our best knowledge, this work presents the first set of nomograms available in the literature specific symptoms of the GI syndrome. The prediction capability of these tools will be validated on a independent set of patients. This work was partly supported by Fondazione I. Monzino, Milan No significant financial relationships to disclose.

Late Fecal Incontinence After High-dose Radiotherapy For Prostate Cancer: Better Prediction Using Longitudinal Definitions

2011 ◽  
Vol 81 (2) ◽  
pp. S423
Author(s):  
T. Rancati ◽  
C. Fiorino ◽  
G. Fellin ◽  
V. Vavassori ◽  
A. Monti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Fecal Incontinence ◽  
High Dose

Predicting late fecal incontinence risk after RT for prostate cancer: External independent validation.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 116-116
Author(s):  
Alessandro Cicchetti ◽  
Barbara Avuzzi ◽  
Federica Palorini ◽  
Tiziana Rancati ◽  
Claudio Stucchi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Fecal Incontinence ◽  
Abdominal Surgery ◽  
Average Score ◽  
Calibration Plot ◽  
Clear Trend ◽  
Logistic Analysis ◽  
Potential Risk Factors

116 Background: To validating a predictive model for late fecal incontinence (FI) on a recent population (pop) of prostate cancer patients (pts) treated with radical radiotherapy. NTCP model was derived from literature. Methods: Pop included 267 pts treated with IMRT in 2010-2014. Prescribed dose was between 68 and 80 Gy with conventional and hypo-fractionated (HF, from 2.2 to 2.8 Gy) treatment. Rectal toxicity was scored using the LENT/SOMA. Follow-up (FU) was considered up to 2 years. We chose to validate a model for prediction of chronic FI through multiple measures during FU. Mean FI was defined as the average score during the FU period after RT (Mean incontinence > 1). Literature based multivariate model included: mean rectal dose (Dmean), previous diseases of colon (COLO) and previous abdominal surgery (SURG). Dose distributions were corrected EQD in 2 Gy fractions. Results: 186 pts were available. Mean grade > 1 FI was scored in 18 patients (〜10%). Univariate logistic analysis confirmed the risk factors reported in literature. Similar Odds Ratios (OR) were found for Dmean (1.04vs1.05) and SURG (1.90vs1.50). COLO was not a risk factor for this pop. As consequence, NTCP models including Dmean and Dmean+SURG were evaluated through calibration plot. The models showed a clear trend (increasing observed toxicity rates with predicted risk), but the observed toxicity rates were underestimated (slope〜3, R2〜0.7). Including HF (OR = 2.20, 8.6% vs 17.6%) as a variable into the previous model the calibrations improved significantly (slope〜1, R2〜0.9). Conclusions: The study confirms formerly published results on effect of abdominal surgery and dose to large rectal volumes as potential risk factors for late FI. The overfitting in calibrations could be due to an effect of HF, not included in previous models developed on normofractionated treatments. This effect goes beyond the applied standard correction using LQ model for late effects and also beyond the time recovery correction (slope〜2, R^2〜0.8). Probably we should found a more suitable alpha/beta value for the longitudinal definition (toxicity starting in acute phase and persisting during follow-up) instead of using the assumption settled on incidence of late peak events.

Predicting Late Fecal Incontinence Risk After Radiation Therapy for Prostate Cancer: New Insights From External Independent Validation

2018 ◽  
Vol 102 (1) ◽  
pp. 127-136 ◽  
Author(s):  
Alessandro Cicchetti ◽  
Barbara Avuzzi ◽  
Federica Palorini ◽  
Francesca Ballarini ◽  
Claudio Stucchi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Fecal Incontinence ◽  
Independent Validation

Late Fecal Incontinence After High-Dose Radiotherapy for Prostate Cancer: Better Prediction Using Longitudinal Definitions

2012 ◽  
Vol 83 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Claudio Fiorino ◽  
Tiziana Rancati ◽  
Gianni Fellin ◽  
Vittorio Vavassori ◽  
Emanuela Cagna ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Fecal Incontinence ◽  
High Dose

Pudendal nerve injury in men with fecal incontinence after radiotherapy for prostate cancer

2015 ◽  
Vol 54 (6) ◽  
pp. 882-888 ◽  
Author(s):  
Arun Loganathan ◽  
Ann C. Schloithe ◽  
Jonathon Hutton ◽  
Eric K. Yeoh ◽  
Robert Fraser ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Fecal Incontinence ◽  
Nerve Injury ◽  
Pudendal Nerve ◽  
Pudendal Nerve Injury

Modeling fecal incontinence symptoms 6 years after high-dose radiation for prostate cancer: Clinical and dosimetric predictors.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 71-71
Author(s):  
Giovanni Fellin ◽  
Tiziana Rancati ◽  
Claudio Fiorino ◽  
Vittorio Vavassori ◽  
Emanuela Cagna ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Fecal Incontinence ◽  
Drug Prescription ◽  
Surrogate Endpoint ◽  
Continuous Variable ◽  
High Dose ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
The Mean ◽  
Pre Treatment

71 Background: To evaluate the incidence of late fecal incontinence (linc) after high-dose radiotherapy (RT) in prostate cancer patients (pts) accrued in AIROPROS 0102 trial (RT doses: 70-80Gy, 1.8-2Gy/fr) and to model the relationship between linc and clinical/dosimetric factors. Methods: Self-reported questionnaires of 515 pts with a minimum follow up of 6 yrs were analyzed with respect to linc. G1 linc was scored if unintentional stool discharge was “sometimes” experienced, G2 linc if unintentional stool discharge was “often” experienced or if pts sporadically used sanitary pads; G3 if pts reported daily unintentional stool discharge or use of sanitary pad >2 times/week. Correlation between pre-treatment morbidities, hormonal therapy, drug prescription, presence of diabetes or hypertension, abdominal surgery prior to RT (SURG), presence of G2-G3 acute fecal incontinence (ACUINC), pelvic nodes and seminal vesicles irradiation, mean rectal dose, dose-volume histograms constraints (from V20Gy to V75Gy) and linc was investigated by uni- and multivariate (MVA) logistic analyses. 347/515 pts had at least 3 toxicity questionnaires in the first 36 mos after the end of RT. Correlation between the mean score of fecal incontinence in the first 36 mos and linc at 6 yrs was also investigated. Results: 50/515 G1, 3/515 G2 and 3/515 G3 linc were reported. In MVA, V40Gy (continuous variable, p=0.09, OR=1.015), use of antihypertensives (protective factors, p=0.005, OR=0.38), SURG (p=0.004, OR=4.7), presence of haemorrhoids (p=0.008, OR=2.6) and ACUINC (p=0.007, OR=4.4) resulted to be correlated to linc. Based on MVA results, a nomogram was developed. Linc at 6 yrs was also correlated to the mean incontinence scores in the first 36 mos (p<0.0001): pts without linc at 6 yrs had a mean score of 0.1 during the first 36 mos, while pts with G1 and with G2-G3 linc at 6 yrs had a mean score of 0.5 and 0.78 during the first 36 mos, respectively. Conclusions: Mean score for incontinence during the first 36 mos after RT can be used as a surrogate endpoint for late (>6yrs) fecal incontinence. Linc is correlated to clinical and dosimetric risk factors and individualised toxicity prediction can be performed through a nomogram.

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