Effect of pretreatment prostate volume on urinary quality of life following intensity-modulated radiation therapy for localized prostate cancer

Abstract

BackgroundThe aim of this study was to describe the effect of pretreatment prostate volume on urinary quality of life after intensity-modulated radiation therapy (IMRT) for clinically localized prostate cancer.MethodsA total of 368 men treated with prostate IMRT (77.4–81 Gy) were stratified into three gland volume groups, ie, <30 g (group 1), 30–60 g (group 2), and >60 g (group 3). Post-IMRT urinary function was evaluated by National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 genitourinary guidelines at one year post-IMRT, and surveyed by the International Prostate Symptom Score (IPSS) before treatment, and then at one month and one year post-IMRT.ResultsLate (one year post-IMRT) CTCAE version 4.0 genitourinary toxicity occurred in 11/368 (3.0%) men, but was not severe (grade ≥ 3); total toxicity was similar between the prostate volume groups (P = 0.86). Continuous prostate volume neither correlated with (P = 0.50) nor predicted late genitourinary toxicity (univariate odds ratio 0.99, 95% confidence interval 0.96–1.02). The total IPSS cohort, group 1 (<30 g) and 2 (30–60 g), showed a similar IPSS trend of elevation from pretreatment baseline to one month post-IMRT (each P < 0.01), then a reduction to baseline at one year (each P < 0.01). Group 3 (>60 g) had the highest pretreatment IPSS, but uniquely showed a better urinary symptom trend than the smaller volume groups, with similar IPSS from baseline to one month post-IMRT (P = 0.88) and improved post-treatment IPSS from baseline at one year (P = 0.003).ConclusionPretreatment prostate volume and initial IPSS scores were not associated with increased late genitourinary toxicity after IMRT in our series. Patients with smaller prostates had an initial increase in urinary symptoms, but returned to baseline at one year. Larger prostate glands (>60 g) had comparatively worse pretreatment symptoms, but at one year showed an overall improvement in IPSS versus baseline.

Intensity-modulated radiation therapy from 70Gy to 80Gy in prostate cancer: six- year outcomes and predictors of late toxicity

“…Recent data from an analysis of 1002 pts treated with high-dose IMRT (86.4Gy) demonstrated that baseline IPSS >15 vs. ≤15 was an independent predictor of grade ≥2 late toxicity [ 26 ]. Hoffman et al demonstrated that men with larger prostate pre-treatment volume have an increased risk of late toxicity [ 37 ], knowing that larger prostate volumes are correlated with higher baseline IPSS [ 38 ]. Nevertheless, no clear threshold value could be identified from the published literature.…”

Urinary function and quality of life after radiotherapy for prostate cancer in patients with prior history of surgical treatment for benign prostatic hyperplasia

“…Chevli et al who evaluated 368 patients treated with RT, did not show an association between the volume of the prostate gland (VP) before treatment and urinary toxicity at 1 year [ 23 ]. VP does not appear to be a good indicator of radiotherapy toxicity in patients with or without TURP.…”

Mutational analysis of renal angiomyolipoma associated with tuberous sclerosis complex and the outcome of short-term everolimus therapy

“…AEs were evaluated using a structured questionnaire covering the side effects reported during EXIST 2 or extension studies and were coded using the Medical Dictionary for Regulatory Activities (MedDRA) preferred term 17,19 . Furthermore, adverse events were continuously monitored in every follow-up visit and graded I-V according to the Common Terminology Criteria for Adverse Events (CTCAE) of the National Cancer Institute version 4.03 via investigator assessment 20 . To assess safety, a complete blood count, urinalysis and the levels of electrolytes (blood urea nitrogen, creatinine, glucose, hepatic enzymes, bilirubin, and serum lipids) were also tested in every patient.…”