Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up

Keyes, Mira; Miller, Stacy; Moravan, Veronika; Pickles, Tom; Liu, Mitchell; Spadinger, Ingrid; Lapointe, Vincent; Morris, W James

doi:10.1016/j.ijrobp.2008.11.043

Title: Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up

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Abstract

Purpose: To describe the late transient worsening of urinary symptoms ('urinary symptom flare') in 712 consecutive prostate brachytherapy patients, associated predictive factors, association with rectal and urinary toxicity, and the development of erectile dysfunction. Methods and Materials: Patients underwent implantation between 1998 and 2003 (median follow-up, 57 months). International Prostate Symptom Score (IPSS), Radiation Therapy Oncology Group (RTOG) toxicity, and erectile function data were prospectively collected. Flare was defined as an increase in IPSS of >=5 and of >=8 points greater than the post-treatment nadir. The relationships between the occurrence of flare and the patient, tumor, and treatment characteristics were examined. The Cox proportional hazards method was used to test individual variables and the multivariate models. Results: The incidence of flare was 52% and 30% using the flare definition of an IPSS of >=5 and >=8 points greater than the postimplant nadir, respectively. Of the patients with symptoms, 65% had resolution of their symptoms within 6 months and 91% within 1 year. Flares most commonly occurred 16-24 months after implantation. On multivariate analysis, a greater baseline IPSS and greater maximal postimplant IPSS were the predictors of flare, regardless of the flare definition used. Androgen suppression was a predictor for fewermore »« less

Authors:

Keyes, Mira ^[1]; Miller, Stacy; Moravan, Veronika; Pickles, Tom; Liu, Mitchell; Spadinger, Ingrid; Lapointe, Vincent; Morris, W James ^[1]

Provincial Prostate Brachytherapy Program, British Columbia Cancer Agency, Vancouver, BC (Canada)

Publication Date:: Sun Nov 01 00:00:00 EDT 2009

OSTI Identifier:: 21362196

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 75; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2008.11.043; PII: S0360-3016(08)03848-0; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; ANDROGENS; BRACHYTHERAPY; IODINE 125; MULTIVARIATE ANALYSIS; NEOPLASMS; PROSTATE; TOXICITY; URINE; ANDROSTANES; BETA DECAY RADIOISOTOPES; BIOLOGICAL MATERIALS; BIOLOGICAL WASTES; BODY; BODY FLUIDS; DAYS LIVING RADIOISOTOPES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; GLANDS; HORMONES; INTERMEDIATE MASS NUCLEI; INTERNAL CONVERSION RADIOISOTOPES; IODINE ISOTOPES; ISOTOPES; MALE GENITALS; MATERIALS; MATHEMATICS; MEDICINE; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANIC COMPOUNDS; ORGANS; RADIOISOTOPES; RADIOLOGY; RADIOTHERAPY; STATISTICS; STEROID HORMONES; STEROIDS; THERAPY; WASTES

Citation Formats


                    Keyes, Mira, Miller, Stacy, Moravan, Veronika, Pickles, Tom, Liu, Mitchell, Spadinger, Ingrid, Lapointe, Vincent, and Morris, W James. Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up.  United States: N. p., 2009. 
        Web.  doi:10.1016/j.ijrobp.2008.11.043.

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                    Keyes, Mira, Miller, Stacy, Moravan, Veronika, Pickles, Tom, Liu, Mitchell, Spadinger, Ingrid, Lapointe, Vincent, & Morris, W James. Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up.  United States.  https://doi.org/10.1016/j.ijrobp.2008.11.043

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                    Keyes, Mira, Miller, Stacy, Moravan, Veronika, Pickles, Tom, Liu, Mitchell, Spadinger, Ingrid, Lapointe, Vincent, and Morris, W James. 2009.  
        "Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up".  United States.  https://doi.org/10.1016/j.ijrobp.2008.11.043.

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@article{osti_21362196,

  title        = {Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up},

  author       = {Keyes, Mira and Miller, Stacy and Moravan, Veronika and Pickles, Tom and Liu, Mitchell and Spadinger, Ingrid and Lapointe, Vincent and Morris, W James},

  abstractNote = {Purpose: To describe the late transient worsening of urinary symptoms ('urinary symptom flare') in 712 consecutive prostate brachytherapy patients, associated predictive factors, association with rectal and urinary toxicity, and the development of erectile dysfunction. Methods and Materials: Patients underwent implantation between 1998 and 2003 (median follow-up, 57 months). International Prostate Symptom Score (IPSS), Radiation Therapy Oncology Group (RTOG) toxicity, and erectile function data were prospectively collected. Flare was defined as an increase in IPSS of >=5 and of >=8 points greater than the post-treatment nadir. The relationships between the occurrence of flare and the patient, tumor, and treatment characteristics were examined. The Cox proportional hazards method was used to test individual variables and the multivariate models. Results: The incidence of flare was 52% and 30% using the flare definition of an IPSS of >=5 and >=8 points greater than the postimplant nadir, respectively. Of the patients with symptoms, 65% had resolution of their symptoms within 6 months and 91% within 1 year. Flares most commonly occurred 16-24 months after implantation. On multivariate analysis, a greater baseline IPSS and greater maximal postimplant IPSS were the predictors of flare, regardless of the flare definition used. Androgen suppression was a predictor for fewer flares (IPSS >=5). Diabetes and prostate edema predicted for more frequent flares (IPSS >=8). Patients with flare had a greater incidence of RTOG Grade 3 urinary toxicity and RTOG Grade 2 or greater rectal toxicity. No association was found between erectile dysfunction and the occurrence of flare. Conclusion: Urinary symptom flare is a common, transient phenomenon after prostate brachytherapy. A greater baseline IPSS and maximal postimplant IPSS were the strongest predictive factors. Flare was associated with a greater incidence of late RTOG Grade 3 urinary toxicity and greater rate of late RTOG Grade 2 or greater rectal toxicity.},

  doi          = {10.1016/j.ijrobp.2008.11.043},

  url          = {https://www.osti.gov/biblio/21362196},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 3,

  volume       = 75,

  place        = {United States},

  year         = {Sun Nov 01 00:00:00 EDT 2009},

  month        = {Sun Nov 01 00:00:00 EDT 2009}

}

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