Clinical Factors Predicting Late Severe Urinary Toxicity After Postoperative Radiotherapy for Prostate Carcinoma: A Single-Institute Analysis of 742 Patients

Cozzarini, C.; Fiorino, Claudio; Pozzo, L. Da; Alongi, Filippo; Berardi, G.; Bolognesi, Angelo; Briganti, Alberto; Broggi, S.; Deli, A.M.; Guazzoni, G.; Perna, L.; Pasetti, M.; Salvadori, G.; Montorsi, Francesco; Rigatti, Patrìzio; Muzio, N. Di

doi:10.1016/j.ijrobp.2010.09.027

Cited by 76 publications

(54 citation statements)

References 37 publications

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“…Nevertheless, it should be highlighted that in neither our previous analysis [30] nor in the current analysis did WPRT emerge as a covariate predictive of an increased risk of severe late urinary sequelae.…”

Section: Discussioncontrasting

confidence: 82%

“…Hypertension, which was independently predictive of LGUTOX3 only in the adjuvant setting in our previous study analyzing patients treated with CF after RT [30], significantly increased the risk of LGUTOX3 in the hypofractionated cohort, perhaps by contributing to an impaired healing process of the radiation-induced damage resulting from microangiopathic disease, by being a surrogate for other diseases, and/or because of more frequent examinations.…”

Section: Discussionmentioning

confidence: 87%

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Higher-than-expected Severe (Grade 3–4) Late Urinary Toxicity After Postprostatectomy Hypofractionated Radiotherapy: A Single-institution Analysis of 1176 Patients

et al. 2014

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 87%

Higher-than-expected Severe (Grade 3–4) Late Urinary Toxicity After Postprostatectomy Hypofractionated Radiotherapy: A Single-institution Analysis of 1176 Patients

et al. 2014

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“…6 The 4-year probability of gradeZ2 late GU and GI toxicity-free survival was 79.4% and 83.4% for patients treated with 74 Gy with a boost, as compared with 100% in patients treated with 64 Gy to the PB only. Although our results were comparable to other series delivering doses above 70 Gy 12,20,26,27 and may in part be explained by the use of 3D-CRT techniques for the majority of the patients, we believe that attention should be taken when dose-escalated protocols are employed in the salvage setting. The best fractionation schedule to use for dose-escalated SRT remains to be prospectively investigated in further clinical trials.…”

Section: Discussionsupporting

confidence: 75%

Results of Dose-adapted Salvage Radiotherapy After Radical Prostatectomy Based on an Endorectal MRI Target Definition Model

Zilli¹,

Jorcano²,

Péguret³

et al. 2017

American Journal of Clinical Oncology

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A PSA value >1 ng/mL before salvage and a biochemical progression during RT were both independently correlated with worse bRFS after SRT. By using erMRI to select patients who are most likely expected to benefit from dose-escalated SRT protocols, this dose-adapted SRT approach was associated with good biochemical control and outcome, serving as a hypothesis-generating basis for further prospective trials aimed at improving the therapeutic ratio in the salvage setting.

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“…A last issue is related to the compelling confirmations of the consequential nature of late radiation-induced urinary toxicity, which were recently reported in large, prospectively followed cohorts (5,9,13,(22)(23)(24)(25)(26)(27). This suggests that a relevant fraction of late urinary events are a "consequence" of the exuberant repair process following the acute inflammatory phase and it means that any effort to reduce acute toxicity may impact the occurrence of late events.…”

Section: The Radiation-induced Urinary Syndrome -Facts and Figuresmentioning

confidence: 99%

Understanding Urinary Toxicity after Radiotherapy for Prostate Cancer: First Steps Forward

Rancati

Palorini

Cozzarini

et al. 2017

Tumori

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Tumori 2017; 103(5): [395][396][397][398][399][400][401][402][403][404] REVIEW -BONADONNA LECTURE SERIES may be differently related to the absorbed dose. For example, rectal bleeding arises as a serial effect and is mainly related to the absorption of high doses in small rectal mucosa volumes, whilst fecal incontinence is related to intermediate doses absorbed by large rectal volumes.The development of reliable models of radiation-induced toxicities along with the available level of technology has determined an efficient improvement of the treatment plans, even in dose-escalated or hypofractionated regimens. This is particularly true for moderate and severe rectal toxicities, which had an incidence close to 20% in the 1990s while in the most recent publications they have fallen below 7%-10%.However, an analogous result has not yet been reached in urinary symptoms. This is mainly due to the difficulty in sparing the bladder, which is partially but unavoidably included in the target volume, as well as to the clear lack of knowledge concerning the predictors of urinary toxicity. The main reason for this deficiency is probably the difficulty in following for a sufficiently long time a large number of patients whose clinical and dosimetry data need to be individually and prospectively collected with proper evaluation of urinary symptoms. Some important symptoms (e.g., incontinence) may indeed continuously arise after radiation therapy and their incidence reaches a plateau only many years (typically 5-8) after treatment. The fulfilment of reliable models of radiation-induced urinary sequelae is therefore made particularly challenging by the complexity of symptoms, their evolution over time, and the strong dependence on the baseline situation.It is widely acknowledged that radiation-induced toxicity is a multifactorial problem, depending not only on the delivered

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Clinical Factors Predicting Late Severe Urinary Toxicity After Postoperative Radiotherapy for Prostate Carcinoma: A Single-Institute Analysis of 742 Patients

Cited by 76 publications

References 37 publications

Higher-than-expected Severe (Grade 3–4) Late Urinary Toxicity After Postprostatectomy Hypofractionated Radiotherapy: A Single-institution Analysis of 1176 Patients

Higher-than-expected Severe (Grade 3–4) Late Urinary Toxicity After Postprostatectomy Hypofractionated Radiotherapy: A Single-institution Analysis of 1176 Patients

Results of Dose-adapted Salvage Radiotherapy After Radical Prostatectomy Based on an Endorectal MRI Target Definition Model

Understanding Urinary Toxicity after Radiotherapy for Prostate Cancer: First Steps Forward

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