Auswirkungen des Rektum-Blasen-Vorbereitungsprotokolls auf die Ergebnisse einer externen Strahlentherapie bei Patienten mit Prostatakarzinom

Translated title of the contribution: Impact of a rectal and bladder preparation protocol on prostate cancer outcome in patients treated with external beam radiotherapy

A. Maggio, D. Gabriele, E. Garibaldi, S. Bresciani, E. Delmastro, A. Di Dia, A. Miranti, M. Poli, T. Varetto, M. Stasi, P. Gabriele

Research output: Contribution to journalArticle

Abstract

Purpose and objective: To test the hypothesis that a rectal and bladder preparation protocol is associated with an increase in prostate cancer specific survival (PCSS), clinical disease free survival (CDFS) and biochemical disease free survival (BDFS). Patients and methods: From 1999 to 2012, 1080 prostate cancer (PCa) patients were treated with three-dimensional conformal radiotherapy (3DCRT). Of these patients, 761 were treated with an empty rectum and comfortably full bladder (RBP) preparation protocol, while for 319 patients no rectal/bladder preparation (NRBP) protocol was adopted. Results: Compared with NRBP patients, patients with RBP had significantly higher BDFS (64% vs 48% at 10 years, respectively), CDFS (81% vs 70.5% at 10 years, respectively) and PCSS (95% vs 88% at 10 years, respectively) (log-rank test p < 0.001). Multivariate analysis (MVA) indicated for all treated patients and intermediate high-risk patients that the Gleason score (GS) and the rectal and bladder preparation were the most important prognostic factors for PCSS, CDFS and BDFS. With regard to high- and very high-risk patients, GS, RBP, prostate cancer staging and RT dose were predictors of PCSS, CDFS and BDFS in univariate analysis (UVA). Conclusion: We found strong evidence that rectal and bladder preparation significantly decreases biochemical and clinical failures and the probability of death from PCa in patients treated without daily image-guided prostate localization, presumably since patients with RBP are able to maintain a reproducibly empty rectum and comfortably full bladder across the whole treatment compared with NRPB patients.

Translated title of the contributionImpact of a rectal and bladder preparation protocol on prostate cancer outcome in patients treated with external beam radiotherapy
Original languageGerman
Pages (from-to)722-732
Number of pages11
JournalStrahlentherapie und Onkologie
Volume193
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

Keywords

  • Image-guided radiation therapy
  • Organs at risk
  • Outcome
  • Prostate cancer
  • Rectal/bladder preparation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

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