Late Toxicity and Quality of Life

Geier, Michael; Geinitz, Hans

doi:10.1007/174_2014_1035

Cited by 1 publication

(4 citation statements)

References 112 publications

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“…This is consistent with the mechanism of radiation induced damage, which often manifests at a delayed time 13 . Radiotherapy utilises ionizing radiation to destroy tumour cells by increasing production of free radicals and reactive oxygen species (ROS) that damage structural proteins and genetic material, ultimately leading to cell death 14 . The effects of radiation are however not limited to malignant cells, causing collateral damage to surrounding healthy tissues.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of radiation are however not limited to malignant cells, causing collateral damage to surrounding healthy tissues. Radiation induced damage to vascular endothelial cells generates a reserve of long-lasting free radicals and ROS with subsequent inflammation, vascular hyperplasia, perivascular fibrosis and end vascular occlusion 14 . These pathological changes occur by 6-12 months following radiotherapy, but the resulting bladder fibrosis and degeneration of bladder wall that occurs secondary to vascular ischaemia of the bladder wall is generally seen months to years after radiotherapy 13 .…”

Section: Discussionmentioning

confidence: 99%

“…These pathological changes occur by 6-12 months following radiotherapy, but the resulting bladder fibrosis and degeneration of bladder wall that occurs secondary to vascular ischaemia of the bladder wall is generally seen months to years after radiotherapy 13 . This ultimately results in decreased bladder compliance and contraction 14 . The high rate of poor bladder compliance seen in salvage radiotherapy is likely attributable more to radiotherapy than to RP, with a previous systematic review having shown that although bladder compliance is initially impaired following RP, this tends to recover with time 12,15 .…”

Section: Discussionmentioning

confidence: 99%

“…Two possible explanations are thought to account for this. Firstly, radiotherapy may result in radiation cystitis which is associated with lower urinary tract symptoms 14,19 . It is plausible that with longer follow-up the bladder effects secondary to radiation manifests themselves more prominently, as demonstrated in a study reporting the rate of DO following salvage radiotherapy to be as high as 37.5% at 7.7 years 9 .…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of radiotherapy for localized prostate cancer on bladder function as demonstrated on urodynamics study: A systematic review

Yao

Hoe

Shamout

et al. 2021

CUAJ

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Introduction: This study aimed to describe the effects of bladder function following radiotherapy for localized prostate cancer by performing a systematic review on studies reporting on urodynamic findings after radiotherapy. Methods: This systematic review was conducted in accordance with PRISMA guidelines. The review protocol was registered at PROSPERO (CRD42021229037). A systematic search was conducted using PubMed, Cochrane Library, Scopus, and OVID Embase. Studies were included if they involved men who underwent urodynamic studies following radiotherapy for localized prostate cancer. A total of 798 articles were screened and five articles included. A qualitative analysis was performed. Results: Bladder compliance appears to be impaired following radiotherapy, especially with longer followup. Impaired bladder compliance was reported in 18.8–62.5% of patients following radiotherapy. Bladder capacity was found to be statistically significantly lower following radiotherapy compared to pre-radiotherapy, and when compared with patients who did not undergo pelvic radiotherapy. Bladder outlet obstruction (BOO) persists post-radiotherapy in most patients at three and 18 months post-radiotherapy. De novo detrusor overactivity (DO) of 13.3% has been reported at 18 months post-radiotherapy. This review is limited by the absence of level I/II studies. Conclusions: Radiotherapy for localized prostate cancer results in decreased bladder compliance and capacity demonstrated on urodynamic studies. Resolution of BOO appears less likely in comparison to series on radical prostatectomy. De novo DO may develop following radiotherapy, especially with longer followup. With only low level of evidence studies available at present, further high-quality, prospective studies are important to elucidate the impact of radiotherapy on bladder and urethral function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%