Exploration of Predictive Factors for Acute Radiotherapy-Induced Gastro-Intestinal Symptoms in Prostate Cancer...

Area of Science:

• Oncology
• Gastroenterology
• Inflammation & Metabolism

Background:

• Acute gastrointestinal (GI) toxicity is common in prostate cancer patients undergoing pelvic radiotherapy (RT).
• This toxicity predicts chronic complications, necessitating identification of predictive factors, particularly modifiable ones.
• Understanding these factors is crucial for developing effective supportive interventions.

Purpose of the Study:

• To identify predictive factors for acute GI toxicity in prostate cancer patients receiving pelvic RT.
• To investigate the roles of systemic inflammation (using Systemic Immune-Inflammation Index - SII) and diet quality (using Diet Quality Index - DQI) in GI toxicity.
• To explore the influence of obesity and lifestyle variables on GI outcomes.

Main Methods:

• Prospective observational cohort study of 32 prostate cancer patients undergoing pelvic RT.
• Patient-reported GI symptoms assessed via EORTC QLQ-PRT20 module.
• Clinician-reported toxicity graded using CTCAE v5.0, with analysis of SII, DQI, obesity, and other variables.

Main Results:

• 91% of patients reported worsening GI symptoms during RT.
• Higher SII was independently associated with greater symptom worsening (p=0.001).
• Obesity (p=0.03) and higher DQI (p=0.015) were protective against symptom worsening. Clinician-reported grade ≥2 GI toxicity was less frequent in obese patients (aOR=0.04, p=0.02).

Conclusions:

• Systemic inflammation is linked to increased GI symptom burden during pelvic RT.
• Obesity and higher dietary quality demonstrate protective effects on both patient- and clinician-reported GI outcomes.
• Findings suggest integrating nutritional and inflammatory profiling for personalized RT-related GI outcome management.