Bladder and bowel symptoms with intensity-modulated radiation therapy (IMRT) for prostate cancer (PC).

Abstract

66 Background: Perioperative behavioral therapy is effective in decreasing urinary incontinence, urgency and frequency after radical prostatectomy (RP). We conducted a pilot study to determine if these symptoms occurred with sufficient frequency and impact on quality of life (QoL) to warrant behavioral therapy prior to and during PC IMRT. Methods: Expanded Prostate Cancer Index Composite Short Form (EPIC-26) is sensitive to health-related (HR) QoL effects of PC therapies. We administered EPIC-26 immediately prior to RT (baseline), and 1, 2, 6, and 12 months (mos) from baseline to PC patients undergoing IMRT at University of Alabama and University of Pennsylvania. Paired Wilcoxon’s test was used to compare rates of bladder and bowel symptoms during IMRT. Results: Of 79 men, 48% were black, with mean: age 64.6+6.9 years; BMI 28.3+5.7; Gleason Score 7.3+1.1 and baseline PSA 11.9+23.6ng/mL; 5% had prior TURP, 30% prior RP, 64% adjuvant hormonal therapy, 8% combination brachytherapy. EPIC domain scores worsened for urinary irritative/obstructive (p<.001), UI (p=0.02), and bowel (p<0.001) symptoms during therapy (at 1 month). Conclusions: Urinary and bowel symptoms were common at baseline and increased slightly during IMRT. Studies of behavioral therapy prior to and during IMRT are warranted. [Table: see text]