Faculty Collaboration Database

Acute and late urinary toxicity following radiation in men with an intact prostate gland or after a radical prostatectomy: A secondary analysis of RTOG 94-08 and 96-01. Urol Oncol 2016 Oct;34(10):430.e1-7

Date

07/07/2016

Pubmed ID

27381895

Pubmed Central ID

PMC5035191

DOI

10.1016/j.urolonc.2016.04.015

Scopus ID

2-s2.0-84991106567 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

INTRODUCTION: To estimate the contribution of the prostate gland and prostatic urethral inflammation to urinary symptoms after radiation therapy for prostate cancer, we performed a secondary analysis of urinary toxicity after primary radiation to an intact prostate vs. postprostatectomy radiation to the prostatic fossa in protocols RTOG 94-08 and 96-01, respectively.

MATERIALS AND METHODS: Patients randomized to the radiation-alone arms (without hormone therapy) of the 2 trials were evaluated, including 104 men receiving primary prostate radiation to 68.4Gy on RTOG 94-08 and 371 men receiving 64.8Gy to the prostatic fossa on RTOG 96-01. Acute and late urinary toxicity were scored prospectively by RTOG scales. Chi-square test/logistic regression and cumulative incidence approach/Fine-Gray regression model were used for analyses of acute and late toxicity, respectively.

RESULTS: Grade≥2 acute urinary toxicity was significantly higher after primary prostatic radiation compared with postprostatectomy radiation (30.8% vs. 14.0%; P<0.001), but acute grade≥3 toxicity did not differ (3.8% vs. 2.7%; P = 0.54). After adjusting for age, primary radiation resulted in significantly higher grade≥2 acute urinary toxicity (odds ratio = 3.72; 95% CI: 1.65-8.37; P = 0.02). With median follow-up of 7.1 years, late urinary toxicity was not significantly different with primary vs. postprostatectomy radiation (5-year grade≥2: 16.7% vs. 18.3%; P = 0.65; grade≥3: 6.0% vs. 3.3%; P = 0.24).

CONCLUSIONS: Primary radiation to an intact prostate resulted in higher grade≥2 acute urinary toxicity than radiation to the prostatic fossa, with no difference in late urinary toxicity. Thus, a proportion of acute urinary toxicity in men with an intact prostate may be attributable to inflammation of the prostatic gland or urethra.

Author List

Mak RH, Hunt D, Efstathiou JA, Heney NM, Jones CU, Lukka HR, Bahary JP, Patel M, Balogh A, Nabid A, Leibenhaut MH, Hamstra DA, Roof KS, Jeffrey Lee R, Gore EM, Sandler HM, Shipley WU

Author

Elizabeth M. Gore MD Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Aged
Aged, 80 and over
Follow-Up Studies
Humans
Male
Middle Aged
Prostate
Prostatectomy
Prostatic Neoplasms
Radiation Injuries
Radiotherapy
Severity of Illness Index
Time Factors
Urethra
Urologic Diseases