Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2016 Oct;34(10):430.e1-7.
doi: 10.1016/j.urolonc.2016.04.015. Epub 2016 Jul 2.

Acute and late urinary toxicity following radiation in men with an intact prostate gland or after a radical prostatectomy: A secondary analysis of RTOG 94-08 and 96-01

Raymond H Mak  1 , Daniel Hunt  2 , Jason A Efstathiou  3 , Niall M Heney  4 , Christopher U Jones  5 , Himu R Lukka  6 , Jean-Paul Bahary  7 , Malti Patel  6 , Alexander Balogh  8 , Abdenour Nabid  9 , Mark H Leibenhaut  5 , Daniel A Hamstra  10 , Kevin S Roof  11 , Robert Jeffrey Lee  12 , Elizabeth M Gore  13 , Howard M Sandler  14 , William U Shipley  15
Affiliations
Clinical Trial

Acute and late urinary toxicity following radiation in men with an intact prostate gland or after a radical prostatectomy: A secondary analysis of RTOG 94-08 and 96-01

Raymond H Mak et al. Urol Oncol. 2016 Oct.

Abstract

Introduction: To estimate the contribution of the prostate gland and prostatic urethral inflammation to urinary symptoms after radiation therapy for prostate cancer, we performed a secondary analysis of urinary toxicity after primary radiation to an intact prostate vs. postprostatectomy radiation to the prostatic fossa in protocols RTOG 94-08 and 96-01, respectively.

Materials and methods: Patients randomized to the radiation-alone arms (without hormone therapy) of the 2 trials were evaluated, including 104 men receiving primary prostate radiation to 68.4Gy on RTOG 94-08 and 371 men receiving 64.8Gy to the prostatic fossa on RTOG 96-01. Acute and late urinary toxicity were scored prospectively by RTOG scales. Chi-square test/logistic regression and cumulative incidence approach/Fine-Gray regression model were used for analyses of acute and late toxicity, respectively.

Results: Grade≥2 acute urinary toxicity was significantly higher after primary prostatic radiation compared with postprostatectomy radiation (30.8% vs. 14.0%; P<0.001), but acute grade≥3 toxicity did not differ (3.8% vs. 2.7%; P = 0.54). After adjusting for age, primary radiation resulted in significantly higher grade≥2 acute urinary toxicity (odds ratio = 3.72; 95% CI: 1.65-8.37; P = 0.02). With median follow-up of 7.1 years, late urinary toxicity was not significantly different with primary vs. postprostatectomy radiation (5-year grade≥2: 16.7% vs. 18.3%; P = 0.65; grade≥3: 6.0% vs. 3.3%; P = 0.24).

Conclusions: Primary radiation to an intact prostate resulted in higher grade≥2 acute urinary toxicity than radiation to the prostatic fossa, with no difference in late urinary toxicity. Thus, a proportion of acute urinary toxicity in men with an intact prostate may be attributable to inflammation of the prostatic gland or urethra.

Keywords: Postprostatectomy radiation; Primary prostate cancer radiation therapy; Urinary toxicity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cumulative incidence of grade ≥ 2 late urinary toxicity after radiation therapy in men with intact prostate (RTOG 9408) or post-prostatectomy (RTOG 9601)
Figure 2
Figure 2
Cumulative incidence of grade ≥ 3 late urinary toxicity after radiation therapy in men with IP (RTOG 9408) or post-prostatectomy (RTOG 9601)
See this image and copyright information in PMC

References

    1. Viswanathan AN, Yorke ED, Marks LB, Eifel PJ, Shipley WU. Radiation dose-volume effects of the urinary bladder. International journal of radiation oncology, biology, physics. 2010;76:S116–22. - PMC - PubMed
    1. Mak RH, Viswanathan AN, Shipley WU. Urinary Bladder ALERT• Adverse Late Effects of Cancer Treatment: Springer Berlin Heidelberg. 2014:465–94.
    1. Zelefsky MJ, Aschkenasy E, Kelsen S, Leibel SA. Tolerance and early outcome results of postprostatectomy three-dimensional conformal radiotherapy. International journal of radiation oncology, biology, physics. 1997;39:327–33. - PubMed
    1. Feng M, Hanlon AL, Pisansky TM, Kuban D, Catton CN, Michalski JM, et al. Predictive factors for late genitourinary and gastrointestinal toxicity in patients with prostate cancer treated with adjuvant or salvage radiotherapy. International journal of radiation oncology, biology, physics. 2007;68:1417–23. - PubMed
    1. Wiegel T, Bottke D, Steiner U, Siegmann A, Golz R, Storkel S, et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol. 2009;27:2924–30. - PubMed

Publication types