Urethral Pain Among Prostate Cancer Survivors 1 to 14 Years After Radiation Therapy
| Autor: | Susan L. Tucker, Ulrica Wilderäng, Karl Axel Johansson, Caroline Olsson, Gunnar Steineck, David Alsadius, Niclas Pettersson |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Time Factors media_common.quotation_subject medicine.medical_treatment Population Brachytherapy Pain Urination Radiation Dosage Prostate cancer Urethra Prostate Surveys and Questionnaires Urethral Diseases Prevalence medicine Humans Radiology Nuclear Medicine and imaging Survivors education Aged media_common Aged 80 and over Salvage Therapy education.field_of_study Radiation Radiotherapy business.industry Case-control study Prostatic Neoplasms Middle Aged medicine.disease Confidence interval Surgery Radiation therapy medicine.anatomical_structure Oncology Case-Control Studies business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 85:e29-e37 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2012.08.037 |
| Popis: | Purpose To investigate how treatment-related and non-treatment-related factors impact urethral pain among long-term prostate cancer survivors. Methods and materials Men treated for prostate cancer with radiation therapy at the Sahlgrenska University Hospital in Goteborg, Sweden from 1993 to 2006 were approached with a study-specific postal questionnaire addressing symptoms after treatment, including urethral burning pain during urination (n=985). The men had received primary or salvage external-beam radiation therapy (EBRT) or EBRT in combination with brachytherapy (BT). Prescribed doses were commonly 70 Gy in 2.0-Gy fractions for primary and salvage EBRT and 50 Gy plus 2×10.0 Gy for EBRT+BT. Prostatic urethral doses were assessed from treatment records. We also recruited 350 non-pelvic-irradiated, population-based controls matched for age and residency to provide symptom background rates. Results Of the treated men, 16% (137 of 863) reported urethral pain, compared with 11% (27 of 242) of the controls. The median time to follow-up was 5.2 years (range, 1.1-14.3 years). Prostatic urethral doses were similar to prescription doses for EBRT and 100% to 115% for BT. Fractionation-corrected dose and time to follow-up affected the occurrence of the symptom. For a follow-up≥3 years, 19% of men (52 of 268) within the 70-Gy EBRT+BT group reported pain, compared with 10% of men (23 of 222) treated with 70 Gy primary EBRT (prevalence ratio 1.9; 95% confidence interval 1.2-3.0). Of the men treated with salvage EBRT, 10% (20 of 197) reported urethral pain. Conclusions Survivors treated with EBRT+BT had a higher risk for urethral pain compared with those treated with EBRT. The symptom prevalence decreased with longer time to follow-up. We found a relationship between fractionation-corrected urethral dose and pain. Among long-term prostate cancer survivors, the occurrence of pain was not increased above the background rate for prostatic urethral doses up to 70 Gy3. |
| Databáze: | OpenAIRE |
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