Clinical factors predicting late severe urinary toxicity after postoperative radiotherapy for prostate carcinoma: A single-institute analysis of 742 patients

Cesare Cozzarini, Claudio Fiorino, Luigi Filippo Da Pozzo, Filippo Alongi, Genoveffa Berardi, Angelo Bolognesi, Alberto Briganti, Sara Broggi, Aniko Deli, Giorgio Guazzoni, Lucia Perna, Marcella Pasetti, Giovannella Salvadori, Francesco Montorsi, Patrizio Rigatti, Nadia Di Muzio

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate the clinical factors independently predictive of long-term severe urinary sequelae after postprostatectomy radiotherapy. Patients and Methods: Between 1993 and 2005, 742 consecutive patients underwent postoperative radiotherapy with either adjuvant (n = 556; median radiation dose, 70.2 Gy) or salvage (n = 186; median radiation dose, 72 Gy) intent. Results: After a median follow-up of 99 months, the 8-year risk of Grade 2 or greater and Grade 3 late urinary toxicity was almost identical (23.9% vs. 23.7% and 12% vs. 10%) in the adjuvant and salvage cohorts, respectively. On univariate analysis, acute toxicity was significantly predictive of late Grade 2 or greater sequelae in both subgroups (p 72 Gy (8-year risk, 19% vs. 6%, p =.007) and age >71 years (8-year risk, 16% vs. 6%, p =.006) in the salvage subgroup. Multivariate analysis confirmed the independent predictive role of all the covariates indicated as statistically significant on univariate analysis. Conclusions: The risk of late Grade 2 or greater and Grade 3 urinary toxicity was almost identical, regardless of the RT intent. In the salvage cohort, older age and greater radiation doses resulted in a worse toxicity profile, and younger, hypertensive patients experienced a greater rate of severe late sequelae in the adjuvant setting. The causes of this latter correlation and apparently different etiopathogenesis of chronic damage in the two subgroups were unclear and deserve additional investigation.

Original languageEnglish
Pages (from-to)191-199
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume82
Issue number1
DOIs
Publication statusPublished - Jan 1 2012

Keywords

  • Adjuvant
  • Prostate cancer
  • Radiotherapy
  • Salvage
  • Urinary toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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