Abstract
BackgroundTo evaluate long-term IPSS score and urinary quality of life after radiotherapy for prostate cancer, in patients with prior history of surgical treatment for benign prostatic hyperplasia (BPH).MethodsIn this retrospective study, we reviewed medical records of patients treated in our department, between 2007 and 2013 with surgery for BPH followed by radiotherapy for localized prostate cancer. Patients were contacted to fill in IPSS questionnaire and they were also asked for urinary quality of life. Predictive factors known to be associated with bad urinary function were also analysed.ResultsFifty-nine patients were included in our study. Median age was 70 years. Median follow-up was 4.6 years. Median radiotherapy dose was 78 Gy (5 × 2 Gy/week). Thirty patients (48.5%) received hormone therapy in combination with RT. Main surgery indications were urinary symptoms (65%) and urinary retention (20%). Five-year biochemical-disease free survival was 75% and 5-year clinical relapse free survival was 84%. At the time of the study, the IPSS after radiotherapy was as follows: 0–7: 77.6%; 8–19:20.7%; 20–35: 1.7%. Urinary quality of life was satisfactory for 74.2% of patients. After multivariate analysis, a high dose of RT and a medical history of hypertension were associated with a poorer quality of urinary life (p = 0.04).ConclusionExternal radiotherapy remains an appropriate treatment option without a major risk for deterioration in urinary function in patient with antecedent surgery for BPH. High dose of RT and a medical history of hypertension were associated with a poorer quality of urinary life.
Highlights
To evaluate long-term International prostate symptom score (IPSS) score and urinary quality of life after radiotherapy for prostate cancer, in patients with prior history of surgical treatment for benign prostatic hyperplasia (BPH)
We report on International prostate symptom score (IPSS) and long-term urinary quality of life of patients treated with high dose 3D RT with prior medical history of TransUrethral Resection of the Prostate (TURP)
Following factors were analyzed: initial prostate volume, volume of the prostate removed by TURP, time interval between surgical procedure and radiotherapy, radiotherapy dose to the prostate, volume of the clinical target volume (CTV), volume of the bladder receiving 70 Gy (B70Gy), and comorbidities (Diabetes mellitus and arterial hypertension)
Summary
To evaluate long-term IPSS score and urinary quality of life after radiotherapy for prostate cancer, in patients with prior history of surgical treatment for benign prostatic hyperplasia (BPH). Many patients may have a personal medical history of TURP or significant urinary symptoms at the time of radiotherapy for prostate cancer treatment. The major two late complications of TURP are urethral strictures (2.2–9.8%) and bladder neck contractures (0.3–9.2%) [1]. It has been reported up to 29% of urethral stricture in patients who had radiotherapy after TURP [2]. Mechanical perturbations of the mucosa leading to scarring remain the most commonly reported causative factor, and fibroblast proliferation suggests that a history of multiple TURPs would be a significant risk factor for higher urinary toxicity after RT
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