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Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT
PURPOSE: There are limited data regarding high-dose stereotactic body radiation therapy (SBRT) for prostate cancer in patients with poor baseline urinary function. The purpose of this study was to evaluate genitourinary (GU) toxicity and changes in patient-reported symptom severity scores after pros...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897767/ https://www.ncbi.nlm.nih.gov/pubmed/33665486 http://dx.doi.org/10.1016/j.adro.2020.09.022 |
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author | Gorovets, Daniel Hopkins, Margaret Goldman, Debra A. Abitbol, Ruth Levy Zhang, Zhigang Kollmeier, Marisa McBride, Sean Zelefsky, Michael J. |
author_facet | Gorovets, Daniel Hopkins, Margaret Goldman, Debra A. Abitbol, Ruth Levy Zhang, Zhigang Kollmeier, Marisa McBride, Sean Zelefsky, Michael J. |
author_sort | Gorovets, Daniel |
collection | PubMed |
description | PURPOSE: There are limited data regarding high-dose stereotactic body radiation therapy (SBRT) for prostate cancer in patients with poor baseline urinary function. The purpose of this study was to evaluate genitourinary (GU) toxicity and changes in patient-reported symptom severity scores after prostate SBRT in men with a high pretreatment International Prostate Symptom Score (IPSS). METHODS AND MATERIALS: Seven hundred fifty-three patients treated with prostate SBRT at our institution from 2012 to 2019 were identified, of whom 72 consecutive patients with baseline IPSS ≥15 were selected for this study. GU toxicity according to Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and IPSS were prospectively documented at each follow-up visit. Univariable logistic regression was used to evaluate for potential predictors of GU toxicity. RESULTS: Median follow-up in survivors was 26.8 months. The rates of acute grade 2 and 3 GU toxicity were 20.8% and 1.4%, respectively. The rates of late grade 2 and 3 GU toxicity were 37.5% and 5.6%, respectively. The majority of grade 2+ toxicities resolved by last follow-up, and when toxicities were regraded per CTCAE v5.0, there were no longer any grade 3 adverse events. Total IPSS and individual symptom subscores improved over time. Compared with baseline, median total IPSS at 24 ± 6 months was significantly lower (18 vs 12; P < .001) and the proportion of patients with severe scores (IPSS ≥20) decreased from 29.2% to 13.9%. Pretreatment urinary urgency was associated with late grade 2+ GU toxicity (odds ratio, 2.10; 95% confidence interval, 1.33-3.31; P = .001). CONCLUSIONS: In men with baseline IPSS ≥15 managed with prostate SBRT, the rate of severe GU toxicity was low and patient-reported symptoms generally improved over time. Thus, high pretreatment IPSS should not deter clinicians from offering prostate SBRT. |
format | Online Article Text |
id | pubmed-7897767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-78977672021-03-03 Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT Gorovets, Daniel Hopkins, Margaret Goldman, Debra A. Abitbol, Ruth Levy Zhang, Zhigang Kollmeier, Marisa McBride, Sean Zelefsky, Michael J. Adv Radiat Oncol Clinical Investigation PURPOSE: There are limited data regarding high-dose stereotactic body radiation therapy (SBRT) for prostate cancer in patients with poor baseline urinary function. The purpose of this study was to evaluate genitourinary (GU) toxicity and changes in patient-reported symptom severity scores after prostate SBRT in men with a high pretreatment International Prostate Symptom Score (IPSS). METHODS AND MATERIALS: Seven hundred fifty-three patients treated with prostate SBRT at our institution from 2012 to 2019 were identified, of whom 72 consecutive patients with baseline IPSS ≥15 were selected for this study. GU toxicity according to Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and IPSS were prospectively documented at each follow-up visit. Univariable logistic regression was used to evaluate for potential predictors of GU toxicity. RESULTS: Median follow-up in survivors was 26.8 months. The rates of acute grade 2 and 3 GU toxicity were 20.8% and 1.4%, respectively. The rates of late grade 2 and 3 GU toxicity were 37.5% and 5.6%, respectively. The majority of grade 2+ toxicities resolved by last follow-up, and when toxicities were regraded per CTCAE v5.0, there were no longer any grade 3 adverse events. Total IPSS and individual symptom subscores improved over time. Compared with baseline, median total IPSS at 24 ± 6 months was significantly lower (18 vs 12; P < .001) and the proportion of patients with severe scores (IPSS ≥20) decreased from 29.2% to 13.9%. Pretreatment urinary urgency was associated with late grade 2+ GU toxicity (odds ratio, 2.10; 95% confidence interval, 1.33-3.31; P = .001). CONCLUSIONS: In men with baseline IPSS ≥15 managed with prostate SBRT, the rate of severe GU toxicity was low and patient-reported symptoms generally improved over time. Thus, high pretreatment IPSS should not deter clinicians from offering prostate SBRT. Elsevier 2020-10-12 /pmc/articles/PMC7897767/ /pubmed/33665486 http://dx.doi.org/10.1016/j.adro.2020.09.022 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Investigation Gorovets, Daniel Hopkins, Margaret Goldman, Debra A. Abitbol, Ruth Levy Zhang, Zhigang Kollmeier, Marisa McBride, Sean Zelefsky, Michael J. Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT |
title | Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT |
title_full | Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT |
title_fullStr | Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT |
title_full_unstemmed | Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT |
title_short | Urinary Outcomes for Men With High Baseline International Prostate Symptom Scores Treated With Prostate SBRT |
title_sort | urinary outcomes for men with high baseline international prostate symptom scores treated with prostate sbrt |
topic | Clinical Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897767/ https://www.ncbi.nlm.nih.gov/pubmed/33665486 http://dx.doi.org/10.1016/j.adro.2020.09.022 |
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