MP53-06 RADIOTHERAPY AFTER RADICAL PROSTATECTOMY: EFFECT OF TIMING OF POST-PROSTATECTOMY RADIATION ON FUNCTIONAL OUTCOMES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy (MP53)1 Apr 2020MP53-06 RADIOTHERAPY AFTER RADICAL PROSTATECTOMY: EFFECT OF TIMING OF POST-PROSTATECTOMY RADIATION ON FUNCTIONAL OUTCOMES Heather Huelster*, Aaron Laviana, Daniel Joyce, Tatsuki Koyama, Zhiguo Zhao, Li-Ching Huang, Karen Hoffman, Ralph Conwill, David Penson, and Daniel Barocas Heather Huelster*Heather Huelster* More articles by this author , Aaron LavianaAaron Laviana More articles by this author , Daniel JoyceDaniel Joyce More articles by this author , Tatsuki KoyamaTatsuki Koyama More articles by this author , Zhiguo ZhaoZhiguo Zhao More articles by this author , Li-Ching HuangLi-Ching Huang More articles by this author , Karen HoffmanKaren Hoffman More articles by this author , Ralph ConwillRalph Conwill More articles by this author , David PensonDavid Penson More articles by this author , and Daniel BarocasDaniel Barocas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000915.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The timing of radiation after prostatectomy is controversial, and its effect on patient-reported sexual, urinary, and bowel function is unknown. This study seeks to compare outcomes after radical prostatectomy (RP) and post-prostatectomy radiation as well as elucidate the timing of radiation to allow optimal recovery of function. METHODS: The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective, population-based study of men with localized prostate cancer. Patient-reported functional outcomes were measured using the 26-item Expanded Prostate Index Composite (EPIC-26) at baseline and 6, 12, 36, and 60 months after enrollment. Functional outcomes were compared using multivariable models controlling for baseline demographic and clinical characteristics. RESULTS: Among 1482 CEASAR participants initially treated with RP for clinically localized prostate cancer, 11.5% (N=170) received adjuvant (N=57) or salvage (N=113) external beam radiotherapy. Men who received post-RP radiotherapy had worse scores in all domains compared to RP alone at 5 years of follow up. Compared to men treated with RP alone in an adjusted linear model, salvage radiation was associated with significantly worse domain scores for sexual function (-11.1, 95%CI [-17.0, - 5.3], p<0.001), incontinence (-7.6, [-13.6, -1.6], p=0.014), urinary irritation (-6.1, [-9.7, -2.4], p=0.001), bowel function (-4.5, [-7.4, -1.7], p=0.002), and hormonal function (-3.3, [-6.0, -0.6], p=0.017). Adjuvant radiation was associated with significantly worse incontinence (-11.9, [-20.7, -3.1], p=0.008), urinary irritation (-5.9, [-11.2, -0.6], p=0.030), and hormonal function (-7.3, [-13.6, -1.0], p=0.023) domain scores compared to RP alone at 5 years of follow up. On multivariable regression analysis, radiotherapy administered at 24 months after RP was associated with the smallest decline in sexual domain score, with an adjusted mean difference of -5.3 points (p=0.016) from post-RP baseline. CONCLUSIONS: In men with localized prostate cancer, post-prostatectomy radiation was associated with significantly worse EPIC-26 sexual, urinary, and bowel function domain scores at 5 years compared to RP alone. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e783-e784 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Heather Huelster* More articles by this author Aaron Laviana More articles by this author Daniel Joyce More articles by this author Tatsuki Koyama More articles by this author Zhiguo Zhao More articles by this author Li-Ching Huang More articles by this author Karen Hoffman More articles by this author Ralph Conwill More articles by this author David Penson More articles by this author Daniel Barocas More articles by this author Expand All Advertisement PDF downloadLoading ...