MP14-15 CLINICO-DOSIMETRIC FACTORS PREDICTING LONG-TERM SEVERE URINARY INCONTINENCE AFTER POST-PROSTATECTOMY RT. RESULTS OF A LONGITUDINAL OBSERVATIONAL STUDY.

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy1 Apr 2016MP14-15 CLINICO-DOSIMETRIC FACTORS PREDICTING LONG-TERM SEVERE URINARY INCONTINENCE AFTER POST-PROSTATECTOMY RT. RESULTS OF A LONGITUDINAL OBSERVATIONAL STUDY. Barbara Noris Chiorda, Carla Sini, Claudio Fiorino, Alberto Briganti, Anna Chiara, Chiara Lucrezia Deantoni, Nicola Fossati, Giorgio Gandaglia, Nazareno Suardi, Francesco Montorsi, Nadia Di Muzio, and Cesare Cozzarini Barbara Noris ChiordaBarbara Noris Chiorda More articles by this author , Carla SiniCarla Sini More articles by this author , Claudio FiorinoClaudio Fiorino More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Anna ChiaraAnna Chiara More articles by this author , Chiara Lucrezia DeantoniChiara Lucrezia Deantoni More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Nadia Di MuzioNadia Di Muzio More articles by this author , and Cesare CozzariniCesare Cozzarini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2518AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The fear of RT-induced urinary incontinence (URINC) often controindicates post-prostatectomy RT (POPRT), despite the lack of accurate data about its real incidence and severity. Purpose of this study was to analyze clinico-dosimetric factors predicting severe, self-reported, URINC 1 and 2 after POPRT. METHODS In 2012 an observational study aimed at assessing URINC from POPRT including WPRT was activated. 2 validated questionnaires, IPSS and ICIQ-SF, have to be filled-in by pts at baseline, at RT mid-point and end, at 3 and 6 months after RT end, and every 6 months thereafter. This analysis pertains to the first 101 pts correctly filling the questionnaires at baseline and at 12 months (60 also at 2 years). 54 and 47 pts were treated with ADV and SALV intent after a median of 4 and 38 months, respectively, from RP, with either conventional (n=42) or moderately hypofractionanted (n=59) regimens, at a median 2-Gy equivalent dose (EQD2) to the prostatic bed of 70 and 74 Gy in ADV and SALV cohort, respectively, and a median EQD2 dose of WPRT of 50 Gy. RESULTS The baseline mean ICIQ score was 7.8 and 4.8 in ADV and SALV cohorts, respectively (p=0.009). The corresponding values at 1 and 2 years were 7.4 vs 7.3 and 8.5 vs 7.9, respectively. Severe URINC (( 13 points) was recorded in 23 and 19%, at 1 year, and in 37 and 21%, at 2 years, of pts treated with ADV and SALV intent, respectively (p always (0.20). The 75th quartiles of ICIQ at 12 (ICIQ12) and 24 (ICIQ24) months (12 and 13 points, respectively), were set as end-points for regression logistic analysis. Of note, the “most informative cut-off” of baseline ICIQ with respect to the risk of ICIQ12 was (16 (AUC 86%) and (7 (AUC 87%) in ADV and SALV cohorts, respectively. CONCLUSIONS The risk of long-term severe URINC one and two years after POPRT was higher in pts treated with ADV intent as compared to the SALV cohort, though only pts with extremely severe baseline incontinence in the ADV subgroup experienced a significant risk of ICIQ12. Overall, the risk of ICIQ12 and ICIQ24 is strongly modulated by baseline URINC, and by AAD and higher EQD2, respectively (Figure 1). © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e149 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Barbara Noris Chiorda More articles by this author Carla Sini More articles by this author Claudio Fiorino More articles by this author Alberto Briganti More articles by this author Anna Chiara More articles by this author Chiara Lucrezia Deantoni More articles by this author Nicola Fossati More articles by this author Giorgio Gandaglia More articles by this author Nazareno Suardi More articles by this author Francesco Montorsi More articles by this author Nadia Di Muzio More articles by this author Cesare Cozzarini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...