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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

IPSS subscores over the 36 months of follow-up a Mean IPSS-total score for all patients. b Mean IPSS-Irritative score for all patients. c Mean IPSS-obstructive score for all patients
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Fig2: IPSS subscores over the 36 months of follow-up a Mean IPSS-total score for all patients. b Mean IPSS-Irritative score for all patients. c Mean IPSS-obstructive score for all patients

Mentions: The mean AUA/IPSS score for all patients was 10.48 at baseline, which corresponds with mild-to-moderate lower urinary tract symptoms (Table 2) (Fig. 2a). After 1 month, AUA/IPSS significantly increased to 13.38 (p < .001). The scores returned to baseline by 3 months at 10.64, slightly worsened at 1 year to 11.11, but then decreased below baseline by 2 years with a mean score of 9.00. The median time to IPSS resolution was 3 months with 56.4 % of patients returning to baseline by this time (Fig. 3a). By 9 months, 80.2 % of patients had reached IPSS resolution and by 2 years 95 % of patients treated had resolved. Pretreatment IPSS-I score was 5.21, significantly increasing to 6.97 (p < .001) after 1 month (Fig. 2b). 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, 47.5 % had reached IPSS-I resolution, at 9 months 76.2 % had reached resolution, and at 2 years 91.1 % of patients treated reached IPSS-I resolution (Fig. 3b). The mean IPSS-O score prior to treatment was 5.31 and there was a non-statistically significant increase in the score to 6.45 (p = 0.344) at 1 month (Fig. 2c). 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 % of patients had IPSS-O resolution by 3 months, 82.1 % by 9 months, and 96.0 % by 2 years (Fig. 3c). Total IPSS score and irritative score decreased after an initial spike at 3 months, however all IPSS sub-scores had a minor but not statistically significant increase at 12 months.Table 2


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)

IPSS subscores over the 36 months of follow-up a Mean IPSS-total score for all patients. b Mean IPSS-Irritative score for all patients. c Mean IPSS-obstructive score for all patients
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: IPSS subscores over the 36 months of follow-up a Mean IPSS-total score for all patients. b Mean IPSS-Irritative score for all patients. c Mean IPSS-obstructive score for all patients
Mentions: The mean AUA/IPSS score for all patients was 10.48 at baseline, which corresponds with mild-to-moderate lower urinary tract symptoms (Table 2) (Fig. 2a). After 1 month, AUA/IPSS significantly increased to 13.38 (p < .001). The scores returned to baseline by 3 months at 10.64, slightly worsened at 1 year to 11.11, but then decreased below baseline by 2 years with a mean score of 9.00. The median time to IPSS resolution was 3 months with 56.4 % of patients returning to baseline by this time (Fig. 3a). By 9 months, 80.2 % of patients had reached IPSS resolution and by 2 years 95 % of patients treated had resolved. Pretreatment IPSS-I score was 5.21, significantly increasing to 6.97 (p < .001) after 1 month (Fig. 2b). 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, 47.5 % had reached IPSS-I resolution, at 9 months 76.2 % had reached resolution, and at 2 years 91.1 % of patients treated reached IPSS-I resolution (Fig. 3b). The mean IPSS-O score prior to treatment was 5.31 and there was a non-statistically significant increase in the score to 6.45 (p = 0.344) at 1 month (Fig. 2c). 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 % of patients had IPSS-O resolution by 3 months, 82.1 % by 9 months, and 96.0 % by 2 years (Fig. 3c). Total IPSS score and irritative score decreased after an initial spike at 3 months, however all IPSS sub-scores had a minor but not statistically significant increase at 12 months.Table 2

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