Late Side Effects after Radiation Therapy in Patients with Prostate Cancer: 2D vs 3D vs IMRT

Abstract

Introduction: Prostate adenocarcinoma (PAC) ranks sixth among the most common malignancies in the world. Acute and chronic toxicities from radiotherapy depend on both the radiation dose and the radiotherapy technique (RT), such as two-dimensional radiotherapy (2D-RT), three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). The aims of this study were to identify the secondary effects of radiotherapy on patients with PAC and to correlate these effects with the use of 2D-RT, 3D-RCT, or IMRT and with the use of other treatments, such as radical prostatectomy (RP) and hormonal therapy (HT). Methods: We selected 68 patients and collected data, such as age, type of health insurance, T and N staging, and RT used, from their medical records. Through a semi-structured instrument, the patients were interviewed about late side effects resulting from the RT treatment. Results: Most patients underwent 2D-RT (50%), and the urinary tract was the most affected system. A late effect of incontinence was related to the RP and RT treatments (P<0.05). Patients who underwent RP were more likely to develop incontinence and leakage with coughing/sneezing (P<0.01). However, the prevalence of secondary effects was not associated with a specific type of RT. Although bowel and sexual changes did not show a relationship with a specific type of RT, sexual dysfunction had an association with bowel alterations (P<0.05). Conclusions: The use of both RP and RT increased the risk of effects on bladder function. These results can contribute to the development of new research to improve RT, facilitating access to less harmful techniques, and even mitigating undesirable effects.