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Kyoda Y, Hashimoto K, Takahashi A, Maehana T, Tachikawa K, Muranaka T, Kato S, Kurisu T, Fukuta F, Kirisawa T, Okada M, Kobayashi K, Tanaka T, Hinotsu S, Masumori N. Which characteristics are associated with changes in medication status for lower urinary tract symptoms among patients with prostate cancer receiving external beam radiotherapy? Curr Urol 2024; 18:122-127. [PMID: 39176291 PMCID: PMC11337989 DOI: 10.1097/cu9.0000000000000194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 01/02/2023] [Indexed: 03/29/2023] Open
Abstract
Background We clarified the predictive factors for changes in the status of medications for lower urinary tract symptoms (LUTS) 2 years after local radiotherapy for nonmetastatic prostate cancer. Materials and methods We retrospectively included patients who underwent local external radiotherapy for nonmetastatic prostate cancer in 8 institutions between April 2001 and March 2016. Patients were divided into the medication and no-medication group based on the use of drugs for LUTS before radiotherapy. We defined improvement of LUTS as when the patient did not require medication for LUTS at 24 months after radiotherapy in the medication group and as deterioration when medication was required in the no-medication group. Logistic regression analysis was used to evaluate predictive factors for changes in medication status. Results Altogether, 505 patients were divided into a no-medication group (n = 352) and a medication group (n = 153). The number of patients with deterioration and improvement in LUTS was 49 (14%) and 36 (23%), respectively. In the multivariate analysis, the predictive variables for deterioration were the International Prostate Symptom Score (≥8; odds ratio [OR], 2.21; p = 0.014) and the biopsy Gleason score (≤3 + 4 = 7; OR, 2.430; p = 0.008) in the no-medication group, whereas those for improvement were age (<75 years old; OR, 5.81; p = 0.002), the quality of life score (<3; OR, 3.15; p = 0.028), and a positive biopsy core rate (≥50%; OR, 2.530; p = 0.027) in the medication group. Conclusions These predictive factors for changes in the status of medications for LUTS at 2 years after external radiotherapy may help determine the definitive therapy for nonmetastatic prostate cancer.
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Affiliation(s)
- Yuki Kyoda
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Takahashi
- Department of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan
| | - Takeshi Maehana
- Department of Urology, Muroran City General Hospital, Muroran, Japan
| | | | - Takashi Muranaka
- Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan
| | - Shuichi Kato
- Department of Urology, Oji General Hospital, Tomakomai, Japan
| | - Tomoyo Kurisu
- Department of Urology, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Fumimasa Fukuta
- Department of Urology, Steel Memorial Muroran Hospital, Muroran, Japan
| | | | - Manabu Okada
- Department of Urology, Obihiro Kyokai Hospital, Obihiro, Japan
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shiro Hinotsu
- Department of Medical Statistics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Uematsu T, Torimoto K, Tanaka N, Asakawa I, Hori S, Yamaki K, Nakai Y, Miyake M, Anai S, Hasegawa M, Fujimoto K. Factors affecting urinary frequency after low-dose-rate brachytherapy for prostate cancer. Low Urin Tract Symptoms 2021; 14:4-9. [PMID: 34288506 DOI: 10.1111/luts.12402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Lower urinary tract symptoms are transiently exacerbated by low-dose-rate brachytherapy (LDR-BT) for prostate cancer and recover to pretreatment levels 1 year thereafter. Generally, these symptoms are influenced by temperature. We aimed to search for factors affecting the lower urinary tract symptoms after seed implant including seasons. METHODS We retrospectively enrolled 812 patients who underwent LDR-BT at Nara Medical University Hospital from January 2010 to December 2018 and for whom the International Prostate Symptom Score, Overactive Bladder Symptom Score, and frequency volume charts were available. We investigated the relationships between lower urinary tract symptoms, 24-hours urinary frequency, 24-hours urinary volume before and after seed implant, radiation dose, and season of seed implant. RESULTS The mean age was 69.5 years. The mean prostate volume was 24.2 mL. The International Prostate Symptom Score, Overactive Bladder Symptom Score, and 24-hours urinary frequency increased until 3 months and gradually decreased over 6 months after seed implant. Multiple linear regression analysis revealed that 24-hours urinary frequency at 3 months after seed implant was significantly influenced by external beam radiotherapy, larger prostate volume before implant, higher 24-hours urinary frequency at baseline, larger 24-hours urinary volume at 3 months after implant, and performance of implant in summer. CONCLUSIONS Lower urinary tract symptoms worsened 3 months after seed implant of LDR-BT regardless of the season of implant. The urinary frequency 3 months after seed implant was slightly lower when seed implant was performed in the summer.
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Affiliation(s)
| | | | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, Kashihara, Japan.,Department of Prostate Brachytherapy, Nara Medical University, Kashihara, Japan
| | - Isao Asakawa
- Department of Prostate Brachytherapy, Nara Medical University, Kashihara, Japan.,Department of Radiation Oncology, Nara Medical University, Kashihara, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Kaori Yamaki
- Department of Radiation Oncology, Nara Medical University, Kashihara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Satoshi Anai
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Masatoshi Hasegawa
- Department of Radiation Oncology, Nara Medical University, Kashihara, Japan
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Post Intensity-Modulated Radiation Therapy Urinary Function for Prostate Cancer; A Prospective Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.102170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: At present, there is a lack of evidence concerning urinary complications caused by intensity-modulated radiation therapy (IMRT) used for the management of prostate cancer (PCa). Objectives: This study aimed at identifying the nature and severity of post-IMRT urinary symptoms in patients with PCa. Methods: This prospective study was performed with consecutive patients, who had clinically localized PCa (cT1c-cT2c) and had undergone IMRT treatment from 2016 to 2019. At 1, 6, and 12 months of follow-up, medical history, physical information, prostate-specific antigen values, International Prostate Symptom Score (IPSS), medication use, Radiation Therapy Oncology Group (RTOG), acute and late toxicity, and Q max were collected. Results: A total of 127 patients with a mean age of 71.04 ± 7.1 years received IMRT and underwent 12 months of follow-up. The mean IPSSs at baseline versus those at 1, 6, and 12 months after IMRT was 14.5 ± 6.8 versus 13.3 ± 6.1, 12.3 ± 5.3, and 10.4 ± 4.2, respectively (P < 0.000). The mean prostate volume was 38.2 ± 12.1 cc. At the last follow-up, 31 patients (24.4%) took genitourinary (GU) medications. Conclusions: This study showed that the majority of GU side effects caused by primary IMRT for PCa treatment are transient. Treatment triggered an acute increase in obstructive urinary symptoms, which peaked during the first month after IMRT. In most patients, in the course of 6 months, symptoms returned to baseline.
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Ahn T, Roberts MJ, Strahan A, Malone G, Paterdis J, Wood G, Heathcote P. Improved lower urinary tract symptoms after robot-assisted radical prostatectomy: implications for survivorship, treatment selection and patient counselling. BJU Int 2019; 123 Suppl 5:47-53. [DOI: 10.1111/bju.14717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas Ahn
- Department of Urology; Greenslopes Private Hospital; Brisbane Qld Australia
- Faculty of Medicine; University of Queensland; Brisbane Qld Australia
| | - Matthew J. Roberts
- Department of Urology; Greenslopes Private Hospital; Brisbane Qld Australia
- Faculty of Medicine; University of Queensland; Brisbane Qld Australia
- Department of Urology; Princess Alexandra Hospital; Brisbane Qld Australia
| | - Andrew Strahan
- Department of Urology; Greenslopes Private Hospital; Brisbane Qld Australia
| | - Greg Malone
- Department of Urology; Greenslopes Private Hospital; Brisbane Qld Australia
- Department of Urology; Princess Alexandra Hospital; Brisbane Qld Australia
- Brisbane Urology Clinic; Brisbane Qld Australia
| | - Jason Paterdis
- Department of Urology; Greenslopes Private Hospital; Brisbane Qld Australia
- Brisbane Urology Clinic; Brisbane Qld Australia
- Department of Urology; QEII Jubilee Hospital; Brisbane Qld Australia
| | - Glen Wood
- Department of Urology; Greenslopes Private Hospital; Brisbane Qld Australia
- Faculty of Medicine; University of Queensland; Brisbane Qld Australia
- Brisbane Urology Clinic; Brisbane Qld Australia
| | - Peter Heathcote
- Department of Urology; Greenslopes Private Hospital; Brisbane Qld Australia
- Department of Urology; Princess Alexandra Hospital; Brisbane Qld Australia
- Brisbane Urology Clinic; Brisbane Qld Australia
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Evaluating the effectiveness of the clinical research radiographer undertaking the on-treatment review of clinical trial patients receiving radiotherapy for prostate cancer. JOURNAL OF RADIOTHERAPY IN PRACTICE 2018. [DOI: 10.1017/s1460396918000626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackgroundRadiotherapy clinical trials are at the forefront of modern-day prostate cancer patient management. Patients are reviewed during treatment by clinical oncologists or competent on-treatment review radiographers to minimise treatment toxicities. Clinical Research Radiographers (CRRs) routinely monitor and gather research data from patients participating in clinical trials.PurposeThe aim of this article is to evaluate the effectiveness of the CRR undertaking the on-treatment review of clinical trial patients.MethodAn experienced CRR within the Northern Ireland Cancer Trials Network was supervised by a clinical oncologist to undertake the role of the on-treatment review of patients receiving radiotherapy for prostate cancer. The CRR explored published literature and compiled this written evaluation as part of their advanced practice learning.ResultsThe supervising clinical oncologist verified, following the planned period of supervised practice and academic study, that the CRR was competent to fulfil the role. Evidence of the beneficial synergistic impact of co-joining the roles was experienced at first hand during the undertaking of supervised practice.ConclusionCo-joining the roles and responsibilities of the CRR and the on-treatment review radiographer enhanced the quality of care offered to the patients participating in clinical trials.
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Understanding Urinary Toxicity after Radiotherapy for Prostate Cancer: First Steps Forward. TUMORI JOURNAL 2017; 103:395-404. [DOI: 10.5301/tj.5000681] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2017] [Indexed: 01/10/2023]
Abstract
One of the most relevant achievements of Professor Gianni Bonadonna was the implementation of the methodology of controlled clinical trials in medical oncology. It is valid for all cancer types, oncological disciplines and clinical endpoints, both survival and toxicity. This narrative review reports on the status of the current knowledge of the radiation-induced urinary syndrome after external-beam radiotherapy for prostate cancer. In recent years, the syndrome has been the object of large-scale prospective observational trials specifically devoted to investigating the association of patient and treatment features with acute/late urinary toxicity. The first results of these trials allow initial attempts at predictive modeling, which can serve as a basis for the optimization of patient selection and treatment planning.
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Hsiao CP, Chen MK, Meyers KJ, Saligan LN. Symptoms predicting health-related quality of life in prostate cancer patients treated with localized radiation therapy. Fam Med Community Health 2017; 5:119-128. [PMID: 30263893 PMCID: PMC6155995 DOI: 10.15212/fmch.2017.0133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective Patient-reported health-related quality-of-life (HRQOL) measures can provide guidance for treatment decision making, symptom management, and discharge planning. HRQOL is often influenced by the distress experienced by patients from disease or treatment-related symptoms. This study aimed to identify symptoms that can predict changes in HRQOL in men undergoing external beam radiation therapy (EBRT) for nonmetastatic prostate cancer (NMPC). Methods Fifty-one men with NMPC scheduled for EBRT were assessed at the baseline, at the midpoint of EBRT, and at the end of EBRT. All participants received 38–42 daily doses of EBRT (five times a week), depending on the stage of their disease. Validated questionnaires were administered to evaluate depressive symptoms, urinary and sexual functions, bowel issues, symptom-related distress, fatigue, and HRQOL. Pearson correlations, repeated-measures ANOVA, and multiple regressions examined the relationships among variables. Results Intensification of symptoms and increased symptom-related distress, with a corresponding decline in HRQOL, were observed during EBRT in men with NMPC. Changes in symptoms and symptom distress were associated with changes in HRQOL at the midpoint of EBRT (r=−0.37 to −0.6, P=0.05) and at the end of EBRT (r=−0.3 to −0.47, P=0.01) compared with the baseline. The regression model comprising age, body mass index, Gleason score, T category, androgen-deprivation therapy use, radiation dose received, symptoms (urinary/sexual/bowel problems, fatigue), and overall symptom distress explained 70% of the variance in predicting HRQOL. Urinary problems and fatigue significantly predicted the decline in HRQOL during EBRT. Conclusion Identifying specific symptoms that can influence HRQOL during EBRT for NMPC can provide feasible interventional targets to improve treatment outcomes.
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Affiliation(s)
- Chao-Pin Hsiao
- The Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Mea-Kuang Chen
- University of Arizona, 3009 E 4th St. Tucson, AZ 85716, USA
| | - Kathy J Meyers
- The Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Leorey N Saligan
- National Institute of Nursing Research, Division of Intramural Research, National Institutes of Health, 9000 Rockville Pike, Building 3, Room 5E14, Bethesda, MD 20892, USA
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