External Beam Radiotherapy for Prostate Cancer: Urinary Outcomes for Men With High International Prostate Symptom Scores (IPSS)

Journal Article · Fri Jul 15 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.03.040· OSTI ID:21587605

Malik, Renuka ^[1]; Jani, Ashesh B ^[2]

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1. Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL (United States)
2. Department of Radiation Oncology, Emory University, Atlanta, GA (United States)

Purpose: To report the urinary outcome of men treated for prostate cancer with external beam radiotherapy (EBRT) who have pretreatment obstructive urinary symptoms (International Prostate Symptom Score [IPSS] {>=}15). Methods and Materials: We treated 368 patients with EBRT for localized prostate cancer, and pre- and post-radiotherapy (RT) IPSSs were recorded. In total, 80 men had an IPSS {>=}15, 48% of whom were taking genitourinary (GU) medications before RT. The IPSS was followed over time and analyzed as a pretreatment factor against Radiation Therapy Oncology Group acute and late GU toxicity. Results: The median follow-up was 44 months. Among men with a pre-RT IPSS {>=}15, the median IPSS at baseline, first follow-up, and last follow-up was 18 (range, 15 to 34), 17 (range, 0 to 32), and 13 (range, 0 to 34), respectively. The mean patient declines in IPSS from baseline to first and last follow-up were -3.6 points (p < 0.0004) and -6.9 points (p < 0.0001), respectively. At last follow-up, 43 men (54%) took GU medications. Pre-RT IPSS {>=}15 vs. {<=}14 was associated with a higher incidence of Grade {>=}2 acute GU toxicity (64% vs. 42%, p = 0.0005), and 4-year freedom from Grade {>=}2 late GU toxicity was 38% vs. 64% (p < 0.0001). There was no greatly increased risk of Grade {>=}3 late GU toxicity for men with IPSS {>=}15 (4-year freedom from Grade {>=}3 late GU toxicity of 90% vs. 96%, p = 0.0964). Conclusions: Although the improvement is not immediate, men with moderate to severe obstructive GU symptoms can have improvement in urinary function after EBRT, without significant risk for severe morbidity.

• OSTI ID: 21587605
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 80; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
DISEASE INCIDENCE
DISEASES
GLANDS
HAZARDS
MALE GENITALS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PROSTATE
RADIOLOGY
RADIOTHERAPY
SYMPTOMS
THERAPY
TOXICITY