Title |
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
|
---|---|
Published in |
Urologic Oncology, July 2016
|
DOI | 10.1016/j.urolonc.2016.04.015 |
Pubmed ID | |
Authors |
Raymond H. Mak, Daniel Hunt, Jason A. Efstathiou, Niall M. Heney, Christopher U. Jones, Himu R. Lukka, Jean-Paul Bahary, Malti Patel, Alexander Balogh, Abdenour Nabid, Mark H. Leibenhaut, Daniel A. Hamstra, Kevin S. Roof, Robert Jeffrey Lee, Elizabeth M. Gore, Howard M. Sandler, William U. Shipley |
Abstract |
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. 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. 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). 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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Scientists | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 49 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 8 | 16% |
Student > Postgraduate | 6 | 12% |
Other | 5 | 10% |
Student > Master | 5 | 10% |
Student > Bachelor | 3 | 6% |
Other | 12 | 24% |
Unknown | 10 | 20% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 17 | 35% |
Nursing and Health Professions | 3 | 6% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 6% |
Agricultural and Biological Sciences | 2 | 4% |
Business, Management and Accounting | 1 | 2% |
Other | 8 | 16% |
Unknown | 15 | 31% |