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Predictive factors for acute and late urinary toxicity after permanent interstitial brachytherapy in J apanese patients
Author(s) -
Tanimoto Ryuta,
Bekku Kensuke,
Katayama Norihisa,
Kobayashi Yasuyuki,
Ebara Shin,
Araki Motoo,
Takemoto Mitsuhiro,
Yanai Hiroyuki,
Nasu Yasutomo,
Kumon Hiromi
Publication year - 2013
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12050
Subject(s) - medicine , brachytherapy , international prostate symptom score , prostate cancer , prostate brachytherapy , prostate , urinary system , urology , univariate analysis , toxicity , radiation therapy , lower urinary tract symptoms , multivariate analysis , cancer
Objectives To describe the frequency of and to determine predictive factors associated with R adiation T herapy O ncology G roup urinary toxicity in prostate brachytherapy patients. Methods From J anuary 2004 to A pril 2011, 466 consecutive J apanese patients underwent permanent iodine‐125‐seed brachytherapy (median follow up 48 months). International P rostate S ymptom S core and R adiation T herapy O ncology G roup toxicity data were prospectively collected. Prostate volume, International P rostate S ymptom S core before and after brachytherapy, and postimplant analysis were examined for an association with urinary toxicity, defined as R adiation T herapy O ncology G roup urinary toxicity of G rade 1 or higher. Logistic regression analysis was used to examine the factors associated with urinary toxicity. Results The rate of R adiation T herapy O ncology G roup urinary toxicity grade 1 or higher at 1, 6, 12, 24, 36 and 48 months was 67%, 40%, 21%, 31%, 27% and 28%, respectively. Grade 2 or higher urinary toxicity was less than 1% at each time‐point. International P rostate S ymptom S core was highest at 3 months and returned to normal 12 months after brachytherapy. On univariate analysis, patients with a larger prostate size, greater baseline International P rostate S ymptom S core, higher prostate V 100, higher prostate V 150, higher prostate D 90 and a greater number of seeds had more acute urinary toxicities at 1 month and 12 months after brachytherapy. On multivariate analysis, significant predictors for urinary toxicity at 1 month and 12 months were a greater baseline International P rostate S ymptom S core and prostate V 100. Conclusions Most urinary symptoms are tolerated and resolved within 12 months after prostate brachytherapy. Acute and late urinary toxicity after brachytherapy is strongly related to the baseline International P rostate S ymptom S core and prostate V 100.