Pretreatment Nomogram to Predict the Risk of Acute Urinary Retention After I-125 Prostate Brachytherapy

Journal Article · Tue Nov 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.06.009· OSTI ID:21590442

Vulpen, Marco van; Battermann, Jan J ^[1]; Roermund, Joep G. van ^[2]; Saibishkumar, Elantholi P ^[3]; Monninkhof, Evelyn M ^[4]

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1. Department of Radiation Oncology, University Medical Center Utrecht (Netherlands)
2. Department of Urology, University Medical Center Utrecht (Netherlands)
3. Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON (Canada)
4. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (Netherlands)

Purpose: Acute urinary retention (AUR) after iodine-125 (I-125) prostate brachytherapy negatively influences long-term quality of life and therefore should be prevented. We aimed to develop a nomogram to preoperatively predict the risk of AUR. Methods: Using the preoperative data of 714 consecutive patients who underwent I-125 prostate brachytherapy between 2005 and 2008 at our department, we modeled the probability of AUR. Multivariate logistic regression analysis was used to assess the predictive ability of a set of pretreatment predictors and the additional value of a new risk factor (the extent of prostate protrusion into the bladder). The performance of the final model was assessed with calibration and discrimination measures. Results: Of the 714 patients, 57 patients (8.0%) developed AUR after implantation. Multivariate analysis showed that the combination of prostate volume, IPSS score, neoadjuvant hormonal treatment and the extent of prostate protrusion contribute to the prediction of AUR. The discriminative value (receiver operator characteristic area, ROC) of the basic model (including prostate volume, International Prostate Symptom Score, and neoadjuvant hormonal treatment) to predict the development of AUR was 0.70. The addition of prostate protrusion significantly increased the discriminative power of the model (ROC 0.82). Calibration of this final model was good. The nomogram showed that among patients with a low sum score (<18 points), the risk of AUR was only 0%-5%. However, in patients with a high sum score (>35 points), the risk of AUR was more than 20%. Conclusion: This nomogram is a useful tool for physicians to predict the risk of AUR after I-125 prostate brachytherapy. The nomogram can aid in individualized treatment decision-making and patient counseling.

• OSTI ID: 21590442
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 81; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BLADDER
BODY
BRACHYTHERAPY
CALIBRATION
DAYS LIVING RADIOISOTOPES
DECISION MAKING
DIAGRAMS
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
FORECASTING
GLANDS
HAZARDS
HORMONES
INFORMATION
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
IODINE 125
IODINE ISOTOPES
ISOTOPES
MALE GENITALS
MATHEMATICS
MEDICINE
MULTIVARIATE ANALYSIS
NEOPLASMS
NOMOGRAMS
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PERFORMANCE
PROSTATE
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
REGRESSION ANALYSIS
RETENTION
STANDARD OF LIVING
STATISTICS
SYMPTOMS
THERAPY
TOXICITY
URINARY TRACT