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Biason E.1, Mareschal J.2, Weber K.3, Frambati L.3, Rigoli P.2, Zilli T.4, Gotteland C.4, Pichard C.2, Miralbell R.4
1University Hospitals of Geneva, Physical Therapy, Geneva, Switzerland, 2University Hospitals of Geneva, Clinical Nutrition Unit, Geneva, Switzerland, 3University Hospitals of Geneva, Division of Liaison Psychiatry and Crisis Intervention, Geneva, Switzerland, 4University Hospitals of Geneva, Division of Radiation Oncology, Geneva, Switzerland
Background: Androgen deprivation (AD) therapy combined to radiotherapy (RT) is a curative therapeutic option for patients with locally advanced prostate cancer (PC), though with a range of nutritional, physical, and psychological side effects.
Purpose: A multidisciplinary care program was created to help frail patients to prevent and manage those side effects.
Methods: We conducted a longitudinal interventional study in frail patients, presenting either cardiovascular/pulmonary comorbidities, old age (≥75 years), vulnerability ratings or balance impairment. Patients were treated by AD and RT and, benefited from nutritional coaching, supervised biweekly 45min-physical training, and psychological counseling for 2-years. Treatment outcomes included Prostate cancer-related quality of life (QoL), Body Mass Index, Fat Mass Index, and Fat-Free Mass Index derived from bioelectrical impedance analysis, 6 min-Walk Test, Timed Up&Go, handgrip strength, Hospital Anxiety and Depression scale, Mini Mental State Examination. Measures were repeated after 0, 3, 6, 9, 12, 18, 24 months, and 12-months post-study follow-up. A prospective mixed-model design was used to assess longitudinal outcome.
Results: Regression analyzes revealed no significant change over the 2-years, including post-study follow-up. Means of QoL, nutritional, physical, as well as psychological variables remained stable over more than 2-year in the 35 men aged 74 (range, 68-76) years.
Conclusion(s): The expected side effects of AD and RT were not observed in frail PC patients who followed this multidisciplinary care program.
Implications: A mutlidisciplinary care program combining nutritional, physical and psychological support is beneficial for locally advanced prostate cancer frail patients receiving androgen deprivation associated with curative radiotherapy by preventing and managing expected side effects.
Funding acknowledgements: This study was supported by Fundacio Privada CELLEX and University Hospital of Geneva Project of Research and Development Fund
Topic: Oncology, HIV & palliative care
Ethics approval: The Ethics Committee of the University Hospital of Geneva exempted the investigators.
All authors, affiliations and abstracts have been published as submitted.
