Evidence map›Paper›PMID 30706013›Full record

ArticleAdvances in radiation oncology

Analysis of Gastrointestinal Toxicity in Patients Receiving Proton Beam Therapy for Prostate Cancer: A Single-Institution Experience.

Howard J Lee, Meghan W Macomber, Matthew B Spraker, Stephen R Bowen, Daniel Hippe, Angela Fung, Kenneth J Russell, George E Laramore, Ramesh Rengan, Jay Liao and 2 more

Open access · goldAbstract read
In one paragraph

Article in Advances in radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Howard J LeeDuke University School of Medicine, Durham, North Carolina.
Meghan W MacomberDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Matthew B SprakerDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Stephen R BowenDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Daniel HippeDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Angela FungSeattle Cancer Care Alliance Proton Therapy Center, Seattle, Washington.
Kenneth J RussellDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
George E LaramoreDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Ramesh RenganDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Jay LiaoDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Smith ApisarnthanaraxDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Jing ZengDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
University of Washington · USDuke University · USSeattle Cancer Care Alliance · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe characterized both physician- and patient-reported rates of gastrointestinal (GI) toxicity in patients treated with proton beam therapy (PBT) at our institution for prostate adenocarcinoma and identified factors associated with toxicity. METHODS AND MATERIALS: We treated 192 patients with PBT between July 2013 and July 2016. Included patients had ≥1 year of follow-up. Potential preexisting clinical and treatment-related risk factors for GI toxicity were recorded. Common Terminology Criteria for Adverse Events version 4.0 was used to score toxicity. Expanded Prostate Cancer Index Composite (EPIC) bowel domain questionnaires assessed patient-reported quality of life. Associations between grade (GR) 2+ toxicity and clinical, treatment, and dosimetric factors were assessed using Cox models and corresponding hazard ratios.

resultsThe median follow-up was 1.7 years. Most of the observed GI toxicity (>90%) was in the form of rectal bleeding (RB). GR2+ GI toxicity and RB actuarial rates specifically at 2 years were 21.3% and 20.4%, respectively. GR3 toxicity was rare, with only 1 observed RB event. No GR4/5 toxicity was seen. The EPIC bowel domain median score was 96 (range, 61-100) pretreatment, 93 (range, 41-100) at 1 year, 89 (range, 57-100) at 1.5 years, and 89 (range, 50-100) at 2 years. Anticoagulation use was the only factor selected during multivariate analysis for predicting GR2+ RB, with a resulting concordance index of 0.59 (95% confidence interval, 0.48-0.68;

conclusionsPBT was associated with acceptable rates of GR2+ transient GI toxicity, mostly in the form of RB, which correlated with anticoagulation use. High EPIC bowel domain quality of life was maintained in the 2 years after treatment.

Identifiers

PMID30706013
PMCPMC6349581
OpenAlexW2887481266

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.