673 LONG TERM URINARY AND RECTAL TOLERANCE IN PROSTATE CANCER SURVIVORS TREATED WITH DEFINITIVE CONFORMAL RADIOTHERAPY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced I1 Apr 2012673 LONG TERM URINARY AND RECTAL TOLERANCE IN PROSTATE CANCER SURVIVORS TREATED WITH DEFINITIVE CONFORMAL RADIOTHERAPY Miriam A. Knoll, M.D. Xin Pei, Ph.D. Dahlia Sperling, andM.A. Michael J. ZelefskyM.D. Miriam A. KnollMiriam A. Knoll NY, NY More articles by this author , Xin PeiXin Pei NY, NY More articles by this author , Dahlia SperlingDahlia Sperling NY, NY More articles by this author , and Michael J. ZelefskyMichael J. Zelefsky NY, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.755AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report the incidence and patterns of development of urinary and rectal complications in prostate cancer survivors treated with definitive conformal radiation therapy with long term follow up exceeding 12 years. METHODS 111 patients with biopsy-proven prostate cancer were treated with definitive RT, with follow-up ranging from 12-18 years. The median age at last follow-up is 81 years (range 66-91). Fifty three patients (47%) received neo-adjuvant and concurrent androgen deprivation therapy in conjunction with RT. The prognostic risk group in this cohort of patients were as follows: low risk 18% (n= 20), intermediate risk 44% (n= 49 pts), and high risk 38% (n=42). Complications were graded according to the NCI Common Terminology Criteria for Adverse Events version 3.0. All patients in our prostate database who were treated with definitive RT were included in this study, as long as they followed up at our hospital at a minimum follow up of 12 years. RESULTS Eighteen patients (16%) developed hematuria at a median time of 3.5 years after RT; 13 of these 18 patients presented with 2-3 episodes or less which subsequently resolved with further follow up. In two patients, hematuria was chronic and presented intermittently despite interventions. No grade 4 hemorrhagic cystitis was observed. Four patients (3.6%) experienced grade 2 urinary incontinence (spontaneous, pads indicated), presented at a median time of 11.5 months after treatment and resolved at a median of 1 year. Grade 2 rectal bleeding was observed in 6% of this cohort which presented at a median time of 1 year after treatment and its average duration before resolution was 3.8 years. No patients experienced grade 3 rectal bleeding. For rectal incontinence, 4 patients (3.6%) developed grade 1 rectal incontinence at a median delay of 3.5 yrs and 2 patients (1.8%) developed grade 2 rectal incontinence at a median delay of 7.8 years after RT. One patient had a grade 2 urethral stricture at the 10 year follow up and this was successfully treated. The median onset of grade 2 and higher rectal and urinary complications were 2 and 3 years, respectively. Only 12 patients (11%) manifested with a urinary or rectal complication after 10 years of follow up and these were generally transient. CONCLUSIONS Excellent tolerance of conformal radiotherapy is observed beyond 10 years from therapy. Manifestations of complications beyond 10 years is uncommon and such events in this cohort were generally transient. These data dispel the notion that significant complications develop beyond 10 years after radiotherapy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e274-e275 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Miriam A. Knoll NY, NY More articles by this author Xin Pei NY, NY More articles by this author Dahlia Sperling NY, NY More articles by this author Michael J. Zelefsky NY, NY More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...