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Molineros G, Meirovitz A, Wygoda M, Zuaiter M, Yutkin V, Duvdevani M, Hidas G, Gofrit ON. Transurethral Prostatectomy Before or After External Beam Radiotherapy: Complications and Reoperation Rates. Res Rep Urol 2021; 13:175-179. [PMID: 33907693 PMCID: PMC8064713 DOI: 10.2147/rru.s307999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose Patients treated by external beam radiotherapy (EBRT) for localized carcinoma of the prostate (CAP) often suffer from urinary obstruction. While most patients can be treated medically, some require transurethral prostatectomy (TURP) for alleviation of obstruction. The consequences of combing EBRT and TURP are controversial. The objective of this study was to evaluate the success and complication rates of TURP combined with EBRT. Patients and Methods Between 2001 and 2017, 3501 patients underwent TURP. Sixty-six of them were treated with EBRT for CAP. Surgical complications according to the Clavien–Dindo (CD) scale and the need for secondary interventions were compared to 66 randomly selected patients operated on for benign prostatic hyperplasia (BPH). Results Patients who underwent TURP for BPH were significantly older compared to the patients with CAP with an average of 76.4 (SD 4.3) vs 71 (SD 8.2) years, p<0.0001. Substantial post-operative complications were rare in both groups with only a single case of CD grade 3 in each group. However, patients with CAP required significantly more secondary surgeries (21% vs 6%, p=0.02) and significantly more additional interventions (37.9% vs 13.6%, p=0.0025). There was no difference in complication rate, in the need for additional interventions or in the oncological outcome when comparing patients operated before or after EBRT. Conclusion The complication rate of TURP done before or after EBRT is low and comparable to surgery for BPH. However, the rates of secondary surgeries and additional interventions in these patients are high (40%). TURP before or after EBRT provides similar results.
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Affiliation(s)
- Gabriel Molineros
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Amichay Meirovitz
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Marc Wygoda
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Mohammad Zuaiter
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Vladimir Yutkin
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Mordechai Duvdevani
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Guy Hidas
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Ofer N Gofrit
- Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel
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Zhang Y, Li P, Yu Q, Wu S, Chen X, Zhang Q, Fu S. Preliminary exploration of clinical factors affecting acute toxicity and quality of life after carbon ion therapy for prostate cancer. Radiat Oncol 2019; 14:94. [PMID: 31164172 PMCID: PMC6549341 DOI: 10.1186/s13014-019-1303-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 05/22/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose To assess toxicity and quality-of-life (QOL) after carbon ion radiotherapy (CIRT) at the Shanghai Proton and Heavy Ion Center (SPHIC) and identify clinical factors that correlate with urinary, bowel and sexual function. Methods Sixty-four patients with localized prostate cancer admitted from July 2015 to January 2018 underwent CIRT. At baseline and 5 time-points after radiotherapy, we assessed patients’ QOL using the 26-item edition of the Expanded Prostate Cancer Index-Composite (EPIC-26) Chinese version. Logistic regression was performed to identify clinical factors associated with acute genitourinary (GU) toxicity and relative QOL. Results By the end of CIRT, urinary irritation/obstruction temporarily declined (− 7.92 ± 1.76, p < .001). For urinary incontinence, bowel and sexual QOL, the scores remained stable at 2-year follow-up. The occurrences of acute Grade 1 and 2 GU toxicity were 20.3 and 10.9%, respectively, and of late Grade 1 and 2 GU toxicity were 3.1 and 1.6%, respectively. No acute or late gastrointestinal (GI) toxicity occurred. Transurethral resection of the prostate (TURP) was a risk factor that predicted a decline in urinary related QOL, and age made a difference to bowel-related QOL. For sexual QOL, castration status was a remarkable risk factor. An international prostate symptom score (IPSS) ≥8 increased the risk of Grade 1–2 acute GU toxicity 5.3-fold. Conclusion Patients with prostate cancer had favorable QOL after CIRT. IPSS ≥8 was a risk factor to acute GU toxicity, and TURP predicted a decline in urinary QOL. Age was related to bowel QOL, and castration status was associated with sexual QOL. Trial registration Carbon Ion Radiotherapy for the Treatment of Localized Prostate Cancer, NCT02739659. Registered April 15, 2016.
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Affiliation(s)
- Yafang Zhang
- Department of Radiation Oncology, Shanghai Proton and Heavy lon Center, Fudan University Cancer Hospital, No.4365 Kang Xin Road, Shanghai, 201321, China.,Shanghai Engineering Research Center of Proton and Heavy lon Radiation Therapy, Shanghai, 201321, China
| | - Ping Li
- Department of Radiation Oncology, Shanghai Proton and Heavy lon Center, Shanghai, 201321, China.,Shanghai Engineering Research Center of Proton and Heavy lon Radiation Therapy, Shanghai, 201321, China
| | - Qi Yu
- Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai, 200020, China
| | - Shuang Wu
- Department of Radiation Oncology, Shanghai Proton and Heavy lon Center, Fudan University Cancer Hospital, No.4365 Kang Xin Road, Shanghai, 201321, China.,Shanghai Engineering Research Center of Proton and Heavy lon Radiation Therapy, Shanghai, 201321, China
| | - Xue Chen
- Department of Radiation Oncology, Shanghai Proton and Heavy lon Center, Fudan University Cancer Hospital, No.4365 Kang Xin Road, Shanghai, 201321, China.,Shanghai Engineering Research Center of Proton and Heavy lon Radiation Therapy, Shanghai, 201321, China
| | - Qing Zhang
- Department of Radiation Oncology, Shanghai Proton and Heavy lon Center, Shanghai, 201321, China. .,Shanghai Engineering Research Center of Proton and Heavy lon Radiation Therapy, Shanghai, 201321, China.
| | - Shen Fu
- Department of Radiation Oncology, Shanghai Proton and Heavy lon Center, Fudan University Cancer Hospital, No.4365 Kang Xin Road, Shanghai, 201321, China. .,Shanghai Engineering Research Center of Proton and Heavy lon Radiation Therapy, Shanghai, 201321, China. .,Key Laboratory of Nuclear Physics and lon-Beam Application (MOE), Fudan University, Shanghai, 200433, China. .,Department of Radiation Oncology, Shanghai Concord Cancer Hospital, Shanghai, 200020, China.
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