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Dysuria Following Stereotactic Body Radiation Therapy for Prostate Cancer.

Janowski EM, Kole TP, Chen LN, Kim JS, Yung TM, Collins BT, Suy S, Lynch JH, Dritschilo A, Collins SP - Front Oncol (2015)

Bottom Line: Bother associated with dysuria significantly increased from a baseline of 12% to a maximum of 43% at 1 month (p < 0.0001).Dysuria significantly correlated with dose and AUA score on multivariate analysis.Frequency and strain significantly correlated with dysuria on stepwise multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA.

ABSTRACT

Background: Dysuria following prostate radiation therapy is a common toxicity that adversely affects patients' quality of life and may be difficult to manage.

Methods: Two hundred four patients treated with stereotactic body radiation therapy (SBRT) from 2007 to 2010 for localized prostate carcinoma with a minimum follow-up of 3 years were included in this retrospective review of prospectively collected data. All patients were treated to 35-36.25 Gy in five fractions delivered with robotic SBRT with real time fiducial tracking. Dysuria and other lower urinary tract symptoms were assessed via Question 4b (Pain or burning on urination) of the expanded prostate index composite-26 and the American Urological Association (AUA) Symptom Score at baseline and at routine follow-up.

Results: Two hundred four patients (82 low-, 105 intermediate-, and 17 high-risk according to the D'Amico classification) at a median age of 69 years (range 48-91) received SBRT for their localized prostate cancer with a median follow-up of 47 months. Bother associated with dysuria significantly increased from a baseline of 12% to a maximum of 43% at 1 month (p < 0.0001). There were two distinct peaks of moderate to severe dysuria bother at 1 month and at 6-12 months, with 9% of patients experiencing a late transient dysuria flare. While a low level of dysuria was seen through the first 2 years of follow-up, it returned to below baseline by 2 years (p = 0.91). The median baseline AUA score of 7.5 significantly increased to 11 at 1 month (p < 0.0001) and returned to 7 at 3 months (p = 0.54). Patients with dysuria had a statistically higher AUA score at baseline and at all follow-ups up to 30 months. Dysuria significantly correlated with dose and AUA score on multivariate analysis. Frequency and strain significantly correlated with dysuria on stepwise multivariate analysis.

Conclusion: The rate and severity of dysuria following SBRT is comparable to patients treated with other radiation modalities.

No MeSH data available.


Related in: MedlinePlus

EPIC urinary dysuria quality of life changes after SBRT. (A) Epic 4b scores before and after SBRT treatment. (B) Patients were stratified to three groups: moderate–big (0–40), very small–small (41–80), and no problem (81–100).
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Figure 1: EPIC urinary dysuria quality of life changes after SBRT. (A) Epic 4b scores before and after SBRT treatment. (B) Patients were stratified to three groups: moderate–big (0–40), very small–small (41–80), and no problem (81–100).

Mentions: The prevalence of patient reported dysuria prior to and after treatment is shown in Table 3. At baseline, 12% of our cohort reported some level of dysuria, with 1% of those patients feeling it was a moderate to big problem. Levels of patient reported dysuria increased significantly following treatment (Figure 1A; Table 3), with 43% of patients reporting dysuria at 1 month (p < 0.0001), and 9% of patients reporting dysuria as being a moderate to big problem (Figure 1B; Table 3). There were two distinct peaks of moderate to severe dysuria bother at 1 month and at 6–12 months (Figures 1A,B), with 9% of patients reporting a late transient dysuria flare that peaked at 6–9 months. While a low level of dysuria was seen through the first year of follow-up, our 18-month dysuria scores were virtually identical to the baseline values (Figure 1A; Table 3).


Dysuria Following Stereotactic Body Radiation Therapy for Prostate Cancer.

Janowski EM, Kole TP, Chen LN, Kim JS, Yung TM, Collins BT, Suy S, Lynch JH, Dritschilo A, Collins SP - Front Oncol (2015)

EPIC urinary dysuria quality of life changes after SBRT. (A) Epic 4b scores before and after SBRT treatment. (B) Patients were stratified to three groups: moderate–big (0–40), very small–small (41–80), and no problem (81–100).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4490223&req=5

Figure 1: EPIC urinary dysuria quality of life changes after SBRT. (A) Epic 4b scores before and after SBRT treatment. (B) Patients were stratified to three groups: moderate–big (0–40), very small–small (41–80), and no problem (81–100).
Mentions: The prevalence of patient reported dysuria prior to and after treatment is shown in Table 3. At baseline, 12% of our cohort reported some level of dysuria, with 1% of those patients feeling it was a moderate to big problem. Levels of patient reported dysuria increased significantly following treatment (Figure 1A; Table 3), with 43% of patients reporting dysuria at 1 month (p < 0.0001), and 9% of patients reporting dysuria as being a moderate to big problem (Figure 1B; Table 3). There were two distinct peaks of moderate to severe dysuria bother at 1 month and at 6–12 months (Figures 1A,B), with 9% of patients reporting a late transient dysuria flare that peaked at 6–9 months. While a low level of dysuria was seen through the first year of follow-up, our 18-month dysuria scores were virtually identical to the baseline values (Figure 1A; Table 3).

Bottom Line: Bother associated with dysuria significantly increased from a baseline of 12% to a maximum of 43% at 1 month (p < 0.0001).Dysuria significantly correlated with dose and AUA score on multivariate analysis.Frequency and strain significantly correlated with dysuria on stepwise multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA.

ABSTRACT

Background: Dysuria following prostate radiation therapy is a common toxicity that adversely affects patients' quality of life and may be difficult to manage.

Methods: Two hundred four patients treated with stereotactic body radiation therapy (SBRT) from 2007 to 2010 for localized prostate carcinoma with a minimum follow-up of 3 years were included in this retrospective review of prospectively collected data. All patients were treated to 35-36.25 Gy in five fractions delivered with robotic SBRT with real time fiducial tracking. Dysuria and other lower urinary tract symptoms were assessed via Question 4b (Pain or burning on urination) of the expanded prostate index composite-26 and the American Urological Association (AUA) Symptom Score at baseline and at routine follow-up.

Results: Two hundred four patients (82 low-, 105 intermediate-, and 17 high-risk according to the D'Amico classification) at a median age of 69 years (range 48-91) received SBRT for their localized prostate cancer with a median follow-up of 47 months. Bother associated with dysuria significantly increased from a baseline of 12% to a maximum of 43% at 1 month (p < 0.0001). There were two distinct peaks of moderate to severe dysuria bother at 1 month and at 6-12 months, with 9% of patients experiencing a late transient dysuria flare. While a low level of dysuria was seen through the first 2 years of follow-up, it returned to below baseline by 2 years (p = 0.91). The median baseline AUA score of 7.5 significantly increased to 11 at 1 month (p < 0.0001) and returned to 7 at 3 months (p = 0.54). Patients with dysuria had a statistically higher AUA score at baseline and at all follow-ups up to 30 months. Dysuria significantly correlated with dose and AUA score on multivariate analysis. Frequency and strain significantly correlated with dysuria on stepwise multivariate analysis.

Conclusion: The rate and severity of dysuria following SBRT is comparable to patients treated with other radiation modalities.

No MeSH data available.


Related in: MedlinePlus