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Sexual, irritative, and voiding outcomes, following stereotactic body radiation therapy for prostate cancer.

Rana Z, Hong RL, Abugideiri M, McRae D, Cernica G, Mordkin R, Joel AB, Bernstein G, Nasr NM - Radiat Oncol (2015)

Bottom Line: The score remained close to baseline and decreased to 4.00 at 2 years and significantly decreased to 3.74 (p = 0.035) at 3 years. 64.4, 82.1, and 96.0% of patients had IPSS-O resolution by 3 months, 9 months, and 2 years.SHIM score began to improve at 18 months, but was still significantly less than baseline at 12.12 (p = .01).Three year PSA response, reported toxicity, erectile function preservation, and urinary function improvement, shows favorable results.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. zhrana88@gmail.com.

ABSTRACT

Background: Urinary symptoms and sexual dysfunction are the two most common complaints following prostate radiotherapy. The impact of hypofractionated treatment on sexual function, irritative symptoms, and voiding symptoms has not been determined within the same patient population. Here we present our institutional data on sexual function, voiding function, irritative symptoms, and treatment response following SBRT.

Methods: This retrospective analysis includes 102 non-metastatic patients treated with SBRT at a single institution between May 2008 and September 2014. The course of radiotherapy consisted of 36.25 Gy (range 35-40) over five daily fractions. International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM), and PSA were recorded at baseline, 1, 3, 6, 9, 12, 18, 24, and 36 months after treatment.

Results: Median patient age was 72 years old with a median follow-up of 4.3 years. Pretreatment IPSS-I score was 5.21, increasing to 6.97 (p < .001) after 1 month. The mean IPSS-I score returned close to baseline after 3 months to 5.86 and decreased to below baseline after 2 years to 5.09. At 3 months, 9 months, and 2 years, 47.5, 76.2, and 91.1% of patients had reached IPSS-I resolution. The mean IPSS-O score prior to treatment was 5.31 and there was an increase in the score to 6.45 (p = 0.344) at 1 month. The score remained close to baseline and decreased to 4.00 at 2 years and significantly decreased to 3.74 (p = 0.035) at 3 years. 64.4, 82.1, and 96.0% of patients had IPSS-O resolution by 3 months, 9 months, and 2 years. The mean SHIM score prior to treatment was 13.52 and continually decreased to below baseline a year after treatment to 10.56 (p < .001). SHIM score began to improve at 18 months, but was still significantly less than baseline at 12.12 (p = .01).

Conclusions: While an increase in AUA/IPSS score initially occurred, all patients resume normal activities immediately following treatment and the AUA/IPSS symptoms improved from baseline. Irittative symptoms take longer to resolve when compared to obstructive voiding symptoms in patients treated with SBRT. Three year PSA response, reported toxicity, erectile function preservation, and urinary function improvement, shows favorable results.

No MeSH data available.


Related in: MedlinePlus

Median PSA for all patients before and after treatment
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Fig1: Median PSA for all patients before and after treatment

Mentions: The median initial PSA was 5.8 ng/ml (Fig. 1). One month after treatment, the median PSA decreased to 2.8 ng/ml. Six months after treatment the PSA was 1.4 ng/ml and then it continued to decrease to 1 ng/ml after 1 year, 0.5 ng/ml after 2 years, and 0.3 ng/ml after 3 years. There were no biochemical failures and benign PSA bounces occurred in 24 % with a median PSA bounce of 0.6 ng/ml.Fig. 1


Sexual, irritative, and voiding outcomes, following stereotactic body radiation therapy for prostate cancer.

Rana Z, Hong RL, Abugideiri M, McRae D, Cernica G, Mordkin R, Joel AB, Bernstein G, Nasr NM - Radiat Oncol (2015)

Median PSA for all patients before and after treatment
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4554301&req=5

Fig1: Median PSA for all patients before and after treatment
Mentions: The median initial PSA was 5.8 ng/ml (Fig. 1). One month after treatment, the median PSA decreased to 2.8 ng/ml. Six months after treatment the PSA was 1.4 ng/ml and then it continued to decrease to 1 ng/ml after 1 year, 0.5 ng/ml after 2 years, and 0.3 ng/ml after 3 years. There were no biochemical failures and benign PSA bounces occurred in 24 % with a median PSA bounce of 0.6 ng/ml.Fig. 1

Bottom Line: The score remained close to baseline and decreased to 4.00 at 2 years and significantly decreased to 3.74 (p = 0.035) at 3 years. 64.4, 82.1, and 96.0% of patients had IPSS-O resolution by 3 months, 9 months, and 2 years.SHIM score began to improve at 18 months, but was still significantly less than baseline at 12.12 (p = .01).Three year PSA response, reported toxicity, erectile function preservation, and urinary function improvement, shows favorable results.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. zhrana88@gmail.com.

ABSTRACT

Background: Urinary symptoms and sexual dysfunction are the two most common complaints following prostate radiotherapy. The impact of hypofractionated treatment on sexual function, irritative symptoms, and voiding symptoms has not been determined within the same patient population. Here we present our institutional data on sexual function, voiding function, irritative symptoms, and treatment response following SBRT.

Methods: This retrospective analysis includes 102 non-metastatic patients treated with SBRT at a single institution between May 2008 and September 2014. The course of radiotherapy consisted of 36.25 Gy (range 35-40) over five daily fractions. International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM), and PSA were recorded at baseline, 1, 3, 6, 9, 12, 18, 24, and 36 months after treatment.

Results: Median patient age was 72 years old with a median follow-up of 4.3 years. Pretreatment IPSS-I score was 5.21, increasing to 6.97 (p < .001) after 1 month. The mean IPSS-I score returned close to baseline after 3 months to 5.86 and decreased to below baseline after 2 years to 5.09. At 3 months, 9 months, and 2 years, 47.5, 76.2, and 91.1% of patients had reached IPSS-I resolution. The mean IPSS-O score prior to treatment was 5.31 and there was an increase in the score to 6.45 (p = 0.344) at 1 month. The score remained close to baseline and decreased to 4.00 at 2 years and significantly decreased to 3.74 (p = 0.035) at 3 years. 64.4, 82.1, and 96.0% of patients had IPSS-O resolution by 3 months, 9 months, and 2 years. The mean SHIM score prior to treatment was 13.52 and continually decreased to below baseline a year after treatment to 10.56 (p < .001). SHIM score began to improve at 18 months, but was still significantly less than baseline at 12.12 (p = .01).

Conclusions: While an increase in AUA/IPSS score initially occurred, all patients resume normal activities immediately following treatment and the AUA/IPSS symptoms improved from baseline. Irittative symptoms take longer to resolve when compared to obstructive voiding symptoms in patients treated with SBRT. Three year PSA response, reported toxicity, erectile function preservation, and urinary function improvement, shows favorable results.

No MeSH data available.


Related in: MedlinePlus