A Comparison of Urinary and Sexual Function Patient-Reported Outcomes (PROs) Among Treatment Modalities for Prostate Cancer (PCa)

Johnson, Matthew E.; Martin, James; Ruth, Karen; Li, T.; Greenberg, Richard E.; Uzzo, Robert G.; Hayes, S.B.; Smaldone, Marc C.; Kutikov, Alexander; Wong, Yu‐Ning; Viterbo, Rosalia; Chen, D.Y.T.; Sobczak, M.L.; Horwitz, Eric M.

doi:10.1016/j.ijrobp.2014.05.472

Cited by 7 publications

(8 citation statements)

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“… 2 , 7 Several studies also demonstrated no significant long-term changes in patient-reported quality of life after PPRT. 21 , 22 , 23 Collectively, these findings should alleviate any concerns of long-term PPRT toxicity that may lead to underutilization.…”

Section: Discussionmentioning

confidence: 86%

Late toxicity after post-prostatectomy intensity modulated radiation therapy: Evaluating normal-tissue sparing guidelines

Akthar

Wong

Parekh

et al. 2018

Advances in Radiation Oncology

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PurposeDose-volume histogram (DVH) toxicity relationships are poorly defined in men who receive radiation after radical prostatectomy (RP). We evaluated Radiation Therapy Oncology Group (RTOG) study 0534 and institutional intact normal-tissue sparing guidelines, as well as dose to bladder trigone, for ability to minimize late toxicity.Methods and materials164 men received intensity modulated radiation therapy (RT) to a median prostate bed dose of 66.6 Gy at a median of 22 months after RP. 46% of men were prescribed androgen deprivation therapy and pelvic lymph node irradiation to a median dose of 50.4 Gy. DVH relationships for the rectum, bladder, trigone, and bladder excluding the clinical target volume (bladder-CTV) were analyzed against the Common Terminology Criteria for Adverse Events late grade 2 + (G2+) gastrointestinal (GI) and genitourinary (GU) toxicity by log-rank test. RTOG 0534 (rectum V65, 40 Gy ≤35, 55%, and bladder-CTV V65, 40 ≤50, 70%) and intact prostate RT institutional guidelines (rectum V70, 65, 40 ≤20, 40, 80% and bladder V70, 65, 40 ≤30, 60, 80%, respectively) guidelines were evaluated.ResultsWith a median follow-up time of of 33 months, the 4-year freedom from G2 + GI and GU toxicity were both 91%. G2 + GI (n = 12) and GU (n = 15) toxicity included 4% diarrhea (n = 6), 4% hemorrhage (n = 6), 1% proctitis (n = 1), and 4% urinary frequency (n = 7), 1% obstructive (n = 2), 2% cystitis (n = 3), and 3% incontinence (n = 5), respectively. RTOG 0534 rectum and bladder goals were not achieved in 65% and 41% of cases, while the institutional intact prostate goals were not achieved in 21% and 25% of cases, respectively. Neither dose to the bladder trigone nor any of the proposed normal tissue goals were associated with late toxicity (P > .1). In the univariate analysis, age, pelvic RT, RT dose, anticoagulation use, androgen deprivation therapy, time from RP to RT, and tobacco history were not associated with toxicity.ConclusionsMore than 90% of men were free from late G2 + toxicity 4 years after post-RP intensity modulated RT. No tested parameters were associated with late toxicity. In the absence of established normal-tissue DVH guidelines in the postoperative setting, the use of intact guidelines is reasonable.

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Section: Discussionmentioning

confidence: 86%

Late toxicity after post-prostatectomy intensity modulated radiation therapy: Evaluating normal-tissue sparing guidelines

Akthar

Wong

Parekh

et al. 2018

Advances in Radiation Oncology

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“…Results such as these that favor brachytherapy over prostatectomy have been reported numerous times (12,13) and overall indicate the high therapeutic ratio and low cost of prostate brachytherapy relative to that of other treatment options (10,11). However, some argue that LDR brachytherapy could be related to similar or higher decreases in patient-reported quality of life as in patients treated with prostatectomy, intensity-modulated radiation therapy, or high-dose-rate brachytherapy (41,42). Nevertheless, the use of brachytherapy in the United States has been declining (19) in favor of active surveillance for those with low-risk disease and surgery for those with intermediate-or high-risk disease (18).…”

Section: Mri-confirmed Favorable Intermediate-risk Disease Indeed Tmentioning

confidence: 96%

Prospective Phase 2 Trial of Permanent Seed Implantation Prostate Brachytherapy for Intermediate-Risk Localized Prostate Cancer: Efficacy, Toxicity, and Quality of Life Outcomes

Frank

Pugh

Blanchard

et al. 2018

International Journal of Radiation Oncology*Biology*Physics

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“…PROMs have become the new standard for evaluating the patient experience, and progressively being used to shape the way healthcare is funded, provided and managed. 7 This has included studies using PROMs for various modalities of prostate cancer treatments across all grades of disease including active surveillance, watchful waiting, brachytherapy, radical radiotherapy, prostatectomy have also been extensively reported in literature [9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Patient Reported Outcome Measures for Transperineal Template Prostate Mapping Biopsies in the PICTURE Study

et al. 2018

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Transperineal template prostate mapping biopsy causes a high urinary retention rate and a detrimental impact on genitourinary functional outcomes, including deterioration in urinary flow and sexual function. Our findings can be used to ensure adequate counseling about transperineal template prostate mapping biopsies. The results point to a need for strategies such as multiparametric magnetic resonance imaging and targeted biopsies to minimize the harms of transperineal template prostate mapping biopsy.

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A Comparison of Urinary and Sexual Function Patient-Reported Outcomes (PROs) Among Treatment Modalities for Prostate Cancer (PCa)

Cited by 7 publications

References 0 publications

Late toxicity after post-prostatectomy intensity modulated radiation therapy: Evaluating normal-tissue sparing guidelines

Late toxicity after post-prostatectomy intensity modulated radiation therapy: Evaluating normal-tissue sparing guidelines

Prospective Phase 2 Trial of Permanent Seed Implantation Prostate Brachytherapy for Intermediate-Risk Localized Prostate Cancer: Efficacy, Toxicity, and Quality of Life Outcomes

Patient Reported Outcome Measures for Transperineal Template Prostate Mapping Biopsies in the PICTURE Study

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