URINARY FUNCTION FOLLOWING HIGH DOSE INTENSITY MODULATED RADIOTHERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER

You have accessJournal of UrologyCME1 May 2022PD22-03 URINARY FUNCTION FOLLOWING HIGH DOSE INTENSITY MODULATED RADIOTHERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER Shannon McNall, Nathan Colin Wong, Shawn Zimberg, and John Rescigno Shannon McNallShannon McNall More articles by this author , Nathan Colin WongNathan Colin Wong More articles by this author , Shawn ZimbergShawn Zimberg More articles by this author , and John RescignoJohn Rescigno More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002564.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Approximately 1/3 of men undergoing treatment for prostate cancer in the U.S. receive external beam radiotherapy (RT). The International Prostate Symptom Score (IPSS) is a validated tool that assesses urinary function. We assessed pre- and post-RT IPSS in a large cohort of men treated with RT + androgen deprivation therapy (ADT) for clinically localized prostate cancer and examined factors associated with baseline IPSS and worsening IPSS after RT. METHODS: Patients treated with intensity modulated RT at Advanced Radiation Centers of New York from 2006 to 2017 were included. IMRT total dose to the prostate was 81-86Gy in 45-48 fractions/9-10 weeks. High-risk patients were treated with ADT + pelvic lymph node RT to 45Gy. Paired samples t-test with bootstrapping was used for comparison of pre- and post-treatment IPSS (mean + 95% CI). Factors associated with IPSS were evaluated using crosstab analysis and Pearson chi-square. Those significant with p <0.05 were evaluated in multivariate analysis using binary logistic regression. Factors assessed were age, T stage, grade group, NCCN risk group, perineural invasion, >50% cores positive, use of ADT, and use of pelvic lymph node RT. RESULTS: 4,772 men had baseline IPSS prior to RT and 6-18 months post-RT (mean 11.8, median 13.1). Overall, there was minor improvement in urinary function post-RT (p <0.001). When assessed by baseline urinary function, the improvement was clinically significant for those with severe baseline urinary symptoms (Table 1). Association between age and baseline IPSS was significant. Moderate/severe baseline urinary symptoms (pre-RT IPSS >20) were present in 44% of men >60 years and 36% of men <60 (p <0.001). Worsened urinary function after RT was associated with pelvic lymph node RT: 44% vs. 40% (p=0.02). Moderate/severe post-RT urinary function was present in 45% of men who received pelvic lymph node RT vs. 37% of those who did not (p <0.001). CONCLUSIONS: Men with localized prostate cancer and baseline moderate/severe urinary symptoms had improved urinary function 6-18 months post-RT, while those with mild urinary symptoms had a modest worsening of symptoms. RT to the pelvic lymph nodes was independently associated with a worsened one-year urinary function score. These data can help inform patient expectations following RT. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e403 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shannon McNall More articles by this author Nathan Colin Wong More articles by this author Shawn Zimberg More articles by this author John Rescigno More articles by this author Expand All Advertisement PDF DownloadLoading ...