Latent profile analysis of adverse effects associated with endocrine therapy in prostate cancer patients based on the theory of unpleasant symptoms

Abstract

Objective·Based on the theory of unpleasant symptoms, to investigate the current status of adverse effects associated with endocrine therapy in prostate cancer patients, and identify the difference of population specificity in each latent category.Methods·From June 2022 to September 2022, 274 patients with endocrine therapy for prostate cancer in the Urology Department of Renji Hospital, Shanghai Jiao Tong University School of Medicine were selected by convenience sampling method. Adverse reactions associated with endocrine therapy were investigated by basic information questionnaire and simplified Chinese version of the aging male′s symptoms scale. Latent profile analysis was conducted and the differences of population characteristics among categories were assessed based on t-test, variance analysis and multiple Logistic regression. Perform latent profile analysis was performed by using Mplus 8.3 to identify latent classes of endocrine treatment-related adverse events in prostate cancer patients.Results·Adverse reactions associated with endocrine therapy in patients with prostate cancer could be divided into three groups: mild-symptom group (n=96, 35.0%), moderate-symptom group (n=111, 40.5%) and severe-symptom group (n=67,24.5%). Compared to patients with mild symptoms, those in the moderate-symptom group had significant differences in psychosocial adaptation (OR=1.038, 95%CI 1.018‒1.060, P=0.000), and whether genetic detection was performed (OR=0.336, 95%CI 0.129‒0.879, P=0.026). Compared to patients with mild symptoms, those in the severe-symptom group had significant differences in psychosocial adaptation (OR=1.027, 95%CI 1.003‒1.051, P=0.024), disease uncertainty (OR=1.021, 95%CI 1.005‒1.038, P=0.011), M stage (OR=0.354, 95%CI 0.136‒0.924, P=0.034), and prostate specific antigen (PSA) (OR=0.142, 95%CI 0.042‒0.480, P=0.002; OR=0.275, 95%CI 0.083‒0.914, P=0.035).Conclusion·The incidence of adverse reactions associated with endocrine therapy for prostate cancer is high. Adverse effects associated with endocrine therapy in prostate cancer patients can be classified into three categories. There are significant differences in disease metastasis, PSA levels, genetic testing, disease uncertainty, and psychosocial adaptation among prostate cancer patients receiving endocrine therapy in different categories. Healthcare professionals should assess the diverse sociodemographic background, disease-specific factors, and psychosocial status of prostate cancer patients receiving endocrine therapy, and provide targeted support according to their characteristics to help them acquire self-management skills and cope with adverse treatment effects proactively, in line with the precision medicine framework.

Keywords

• prostatic neoplasms
• endocrine therapy
• adverse reaction
• theory of unpleasant symptoms
• latent profile analysis