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
. 2017 Jul-Aug;43(4):628-637.
doi: 10.1590/S1677-5538.IBJU.2016.0189.

Quality of Life after post-prostatectomy intensity modulated radiation therapy to the prostate bed with or without the use of gold fiducial markers for image guidance or higher total radiotherapy doses

Yazan A Abuodeh  1 , Arash O Naghavi  1 , Tzu-Hua Juan  1 , Zhenjun Ma  1 , Richard B Wilder  2
Affiliations

Quality of Life after post-prostatectomy intensity modulated radiation therapy to the prostate bed with or without the use of gold fiducial markers for image guidance or higher total radiotherapy doses

Yazan A Abuodeh et al. Int Braz J Urol. 2017 Jul-Aug.

Abstract

Purpose: To evaluate quality of life (QoL) after post-prostatectomy intensity modulated radiation therapy (IMRT) in the "adjuvant" setting starting within 4 months of radical prostatectomy for adverse features; and "salvage" setting for a PSA≥0.2ng/mL.

Materials and methods: Retrospective review of 130 patients who underwent IMRT to the prostate bed±gold fiducial marker placement for image guidance to 64.8-72.0Gy (median, 70.2Gy) between 2004 and 2013. Higher doses were defined as 70.2-72.0Gy and lower doses were defined as 64.8-68.4Gy. Androgen deprivation therapy (ADT) was given to 4/48 (8%) adjuvant patients and 9/82 (11%) salvage patients. International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM), and Expanded Prostate Cancer Index Composite-26-bowel (EPIC-26-bowel) questionnaires were used to assess urinary, sexual, and bowel QoL, respectively.

Results: Median follow-up was 46 months. There were better urinary (p=0.03) and sexual (p=0.002) QoL scores with adjuvant IMRT relative to salvage IMRT. The use of prostate bed fiducial markers did not significantly affect urinary, sexual, or bowel QoL (p=0.39, p=0.49, and p=0.40, respectively). Higher total radiotherapy doses did not significantly affect urinary, sexual, or bowel QoL (p=0.21, p=0.61, and p=0.36, respectively).

Conclusions: There was no significant change in urinary, sexual, and bowel sexual QoL with post-prostatectomy IMRT regardless of whether prostate bed fiducial markers or higher total radiotherapy doses were used. QoL with IMRT in the present study compares favorably with prior reports for three-dimensional conformal radiation therapy.

Keywords: Postoperative Care; Prostate; Quality of Life.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1. Mean IPSS (urinary QoL) scores with standard error bars in patients who received adjuvant IMRT (─) or salvage IMRT (…) (p=0.03).
Figure 2
Figure 2. Mean SHIM (sexual QoL) scores with standard error bars in patients who received adjuvant IMRT (─) or salvage IMRT (…) (p=0.002).
Figure 3
Figure 3. Mean EPIC-26-bowel QoL scores with standard error bars in patients without fiducial markers (─) or with fiducial markers (…) in their prostate bed (p=0.40).
Figure 4
Figure 4. Mean EPIC-26-bowel QoL scores with standard error bars in patients who received total radiotherapy doses of 64.8-68.4Gy (─) or 70.2-72.0Gy (…) (p=0.36).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Van der Kwast TH, Bolla M, Van Poppel H, Van Cangh P, Vekemans K, Da Pozzo L, et al. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911. J Clin Oncol. 2007;25:4178–4186. - PubMed
    1. Thompson IM, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term follow-up of a randomized clinical trial. J Urol. 2009;181:956–962. - PMC - PubMed
    1. Wiegel T, Bottke D, Steiner U, Siegmann A, Golz R, Störkel 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;27:2924–2930. - PubMed
    1. Freedland SJ, Rumble RB, Finelli A, Chen RC, Slovin S, Stein MN, et al. Adjuvant and salvage radiotherapy after prostatectomy: American Society of Clinical Oncology clinical practice guideline endorsement. J Clin Oncol. 2014;32:3892–3898. - PubMed
    1. McVey GP, Parker C. Adjuvant vs. salvage radiotherapy for pathologically advanced prostate cancer. Curr Opin Urol. 2010;20:229–233. - PubMed