Patient-reported urinary incontinence following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer.

Abstract

PURPOSE:

Urinary incontinence (UI) following prostate radiotherapy is a rare toxicity that adversely affects a patient's quality of life. This study sought to evaluate the incidence of UI following stereotactic body radiation therapy (SBRT) for prostate cancer.

METHODS:

Between February, 2008 and October, 2010, 204 men with clinically localized prostate cancer were treated definitively with SBRT at Georgetown University Hospital. Patients were treated to 35-36.25 Gray (Gy) in 5 fractions delivered with the CyberKnife (Accuray). UI was assessed via the Expanded Prostate Index Composite (EPIC)-26.

RESULTS:

Baseline UI was common with 4.4%, 1.0% and 3.4% of patients reporting leaking > 1 time per day, frequent dribbling and pad usage, respectively. Three year post treatment, 5.7%, 6.4% and 10.8% of patients reported UI based on leaking > 1 time per day, frequent dribbling and pad usage, respectively. Average EPIC UI summary scores showed an acute transient decline at one month post-SBRT then a second a gradual decline over the next three years. The proportion of men feeling that their UI was a moderate to big problem increased from 1% at baseline to 6.4% at three years post-SBRT.

CONCLUSIONS:

Prostate SBRT was well tolerated with UI rates comparable to conventionally fractionated radiotherapy and brachytherapy. More than 90% of men who were pad-free prior to treatment remained pad-free three years following treatment. Less than 10% of men felt post-treatment UI was a moderate to big problem at any time point following treatment. Longer term follow-up is needed to confirm late effects.

• Authors: Leonard N Chen, Simeng Suy, Hongkun Wang, Aditi Bhagat, Jennifer A Woo, Rudy A Moures, Joy S Kim, Thomas M Yung, Siyuan Lei, Brian T Collins, Keith Kowalczyk, Anatoly Dritschilo, John H Lynch, Sean P Collins
• Journal: Radiation oncology (London, England) (Radiat Oncol) Vol. 9 Pg. 148 (Jun 26 2014) ISSN: 1748-717X [Electronic] England
• PMID: 24966110 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Neoplasm Staging
• Patient Outcome Assessment
• Prognosis
• Prospective Studies
• Prostatic Neoplasms (pathology, radiotherapy)
• Quality of Life
• Radiosurgery (adverse effects)
• Retrospective Studies
• Self Report
• United States (epidemiology)
• Urinary Incontinence (epidemiology, etiology)