Comparison of Late Urinary Symptoms Following SBRT and SBRT with IMRT Supplementation for Prostate Cancer

Overview

Journal Curr Urol

Specialty Urology

Date 2018 Jul 13

PMID 29997466

Citations 4

Authors

Li Rebekah Feng

Simeng Suy

Sean P Collins

Jonathan W Lischalk

Berwin Yuan

Leorey N Saligan

Affiliations

Soon will be listed here.

Abstract

Background: Prostate cancer survivors commonly experience late-onset lower urinary tract symptoms following radiotherapy. We aimed to compare lower urinary tract symptoms in patients treated with stereotactic body radiotherapy (SBRT) to those treated with a combination of lower dose SBRT and supplemental intensity-modulated radiotherapy (SBRT + IMRT).

Methods: Subjects with localized prostate carcinoma scheduled to receive SBRT or a combination of SBRT and IMRT were enrolled and followed for up to 2 years after treatment completion. Participants treated with SBRT received 35-36.25 Gy in 5 fractions, while those treated with SBRT + IMRT received 19.5 Gy of SBRT in 3 fractions followed by 45-50.4 Gy of IMRT in 25-28 fractions. Urinary symptoms were measured using the American Urological Association (AUA) Symptom Score.

Results: Two hundred patients received SBRT (52% intermediate risk, 37.5% low risk according to D'Amico classification) and 145 patients received SBRT + IMRT (61.4% high risk, 35.2% intermediate risk). Both groups experienced a transient spike in urinary symptoms 1 month after treatment. More severe late urinary flare (increase in AUA scores ≥ 5 points from baseline to 1 year after treatment completion and an AUA score ≥ 15 at 1 year after treatment) was experienced by patients who received SBRT compared to those treated with SBRT + IMRT.

Conclusion: Participants who received SBRT and supplemental IMRT experienced less severe late urinary flare 1 year after treatment compared to those who received higher dose SBRT alone. This information can be used by clinicians to provide patients with anticipatory counseling to mitigate any psychological burden that comes with unanticipated late urinary toxicities.

Citing Articles

Adjuvant Novel Nanocarrier-Based Targeted Therapy for Lung Cancer.

Sarma K, Akther M, Ahmad I, Afzal O, Altamimi A, Alossaimi M Molecules. 2024; 29(5).

PMID: 38474590 PMC: 10934468. DOI: 10.3390/molecules29051076.

Virtual HDR Boost for Prostate Cancer: Rebooting a Classic Treatment Using Modern Tech.

Wegener E, Samuels J, Sidhom M, Trada Y, Sridharan S, Dickson S Cancers (Basel). 2023; 15(7).

PMID: 37046680 PMC: 10093761. DOI: 10.3390/cancers15072018.

Natural history of lower urinary tract symptoms among men undergoing stereotactic body radiation therapy for prostate cancer with and without a Rectal Hydrogel Spacer.

Alshak M, Eidelberg A, Martinez Diaz S, Stoddard M, Formenti S, Nagar H World J Urol. 2022; 40(5):1143-1150.

PMID: 35182206 DOI: 10.1007/s00345-022-03953-0.

Phase I/II Study of Extreme Hypofractionated Stereotactic Body Radiation Therapy Boost to Prostate for Locally Advanced, Node-Positive and Oligometastatic Cancer.

Narang K, Kadian M, Venkatesan K, Mishra S, Bisht S, Gupta D Cureus. 2021; 12(11):e11751.

PMID: 33403181 PMC: 7773303. DOI: 10.7759/cureus.11751.

References

Joh D, Chen L, Porter G, Bhagat A, Sood S, Kim J . Proctitis following stereotactic body radiation therapy for prostate cancer. Radiat Oncol. 2014; 9:277. PMC: 4272823. DOI: 10.1186/s13014-014-0277-4. View

Oermann E, Slack R, Hanscom H, Lei S, Suy S, Park H . A pilot study of intensity modulated radiation therapy with hypofractionated stereotactic body radiation therapy (SBRT) boost in the treatment of intermediate- to high-risk prostate cancer. Technol Cancer Res Treat. 2010; 9(5):453-62. DOI: 10.1177/153303461000900503. View

De Meerleer G, Vakaet L, Meersschout S, Villeirs G, Verbaeys A, Oosterlinck W . Intensity-modulated radiotherapy as primary treatment for prostate cancer: acute toxicity in 114 patients. Int J Radiat Oncol Biol Phys. 2004; 60(3):777-87. DOI: 10.1016/j.ijrobp.2004.04.017. View

DeSantis C, Lin C, Mariotto A, Siegel R, Stein K, Kramer J . Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin. 2014; 64(4):252-71. DOI: 10.3322/caac.21235. View

Collins S, Suy S, Chen L, Collins B, Lynch J, Dritschilo A . Late urinary symptom flare after prostate stereotactic body radiation therapy. J Clin Oncol. 2014; 32(30):3451-2. DOI: 10.1200/JCO.2014.56.6547. View

Pederson A, Fricano J, Correa D, Pelizzari C, Liauw S . Late toxicity after intensity-modulated radiation therapy for localized prostate cancer: an exploration of dose-volume histogram parameters to limit genitourinary and gastrointestinal toxicity. Int J Radiat Oncol Biol Phys. 2010; 82(1):235-41. DOI: 10.1016/j.ijrobp.2010.09.058. View

Rodrigues G, Warde P, Pickles T, Crook J, Brundage M, Souhami L . Pre-treatment risk stratification of prostate cancer patients: A critical review. Can Urol Assoc J. 2012; 6(2):121-7. PMC: 3328553. DOI: 10.5489/cuaj.11085. View

Resnick M, Koyama T, Fan K, Albertsen P, Goodman M, Hamilton A . Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med. 2013; 368(5):436-45. PMC: 3742365. DOI: 10.1056/NEJMoa1209978. View

Woo J, Chen L, Bhagat A, Oermann E, Kim J, Moures R . Clinical characteristics and management of late urinary symptom flare following stereotactic body radiation therapy for prostate cancer. Front Oncol. 2014; 4:122. PMC: 4033266. DOI: 10.3389/fonc.2014.00122. View

10.

Berry D . Patient-reported symptoms and quality of life integrated into clinical cancer care. Semin Oncol Nurs. 2011; 27(3):203-10. PMC: 3143403. DOI: 10.1016/j.soncn.2011.04.005. View

11.

Chen L, Suy S, Wang H, Bhagat A, Woo J, Moures R . Patient-reported urinary incontinence following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer. Radiat Oncol. 2014; 9:148. PMC: 4083362. DOI: 10.1186/1748-717X-9-148. View

12.

Barry M, Fowler Jr F, OLeary M, Bruskewitz R, HOLTGREWE H, MEBUST W . The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992; 148(5):1549-57; discussion 1564. DOI: 10.1016/s0022-5347(17)36966-5. View

13.

Bhattasali O, Chen L, Woo J, Park J, Kim J, Moures R . Patient-reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer. Radiat Oncol. 2014; 9:52. PMC: 3931491. DOI: 10.1186/1748-717X-9-52. View

14.

Zelefsky M, Levin E, Hunt M, Yamada Y, Shippy A, Jackson A . Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2008; 70(4):1124-9. DOI: 10.1016/j.ijrobp.2007.11.044. View

15.

Evans J, Zhao S, Daignault S, Sanda M, Michalski J, Sandler H . Patient-reported quality of life after stereotactic body radiotherapy (SBRT), intensity modulated radiotherapy (IMRT), and brachytherapy. Radiother Oncol. 2015; 116(2):179-84. DOI: 10.1016/j.radonc.2015.07.016. View

16.

Yu J, Cramer L, Herrin J, Soulos P, Potosky A, Gross C . Stereotactic body radiation therapy versus intensity-modulated radiation therapy for prostate cancer: comparison of toxicity. J Clin Oncol. 2014; 32(12):1195-201. PMC: 3986382. DOI: 10.1200/JCO.2013.53.8652. View

17.

van Tol-Geerdink J, Leer J, van Oort I, van Lin E, Weijerman P, Vergunst H . Quality of life after prostate cancer treatments in patients comparable at baseline. Br J Cancer. 2013; 108(9):1784-9. PMC: 3658523. DOI: 10.1038/bjc.2013.181. View

18.

Keyes M, Miller S, Moravan V, Pickles T, Liu M, Spadinger I . Urinary symptom flare in 712 125I prostate brachytherapy patients: long-term follow-up. Int J Radiat Oncol Biol Phys. 2009; 75(3):649-55. DOI: 10.1016/j.ijrobp.2008.11.043. View

19.

Malik R, Jani A, Liauw S . External beam radiotherapy for prostate cancer: urinary outcomes for men with high International Prostate Symptom Scores (IPSS). Int J Radiat Oncol Biol Phys. 2010; 80(4):1080-6. DOI: 10.1016/j.ijrobp.2010.03.040. View

20.

Rana Z, Hong R, Abugideiri M, McRae D, Cernica G, Mordkin R . Sexual, irritative, and voiding outcomes, following stereotactic body radiation therapy for prostate cancer. Radiat Oncol. 2015; 10:182. PMC: 4554301. DOI: 10.1186/s13014-015-0488-3. View