Predictive Factors for Late Genitourinary and Gastrointestinal Toxicity in Patients With Prostate Cancer Treated With Adjuvant or Salvage Radiotherapy

Mary Feng, Alexandra L. Hanlon, Thomas M. Pisansky, Deborah Kuban, Charles N. Catton, Jeff M. Michalski, Michael J. Zelefsky, Patrick A. Kupelian, Alan Pollack, Larry L. Kestin, Richard K. Valicenti, Theodore L. DeWeese, Howard M. Sandler

Research output: Contribution to journalArticlepeer-review

99 Scopus citations

Abstract

Purpose: To determine the rate and magnitude of late genitourinary (GU) and gastrointestinal (GI) toxicities after salvage or adjuvant radiotherapy (RT) for prostate cancer, and to determine predictive factors for these toxicities. Methods and Materials: A large multi-institutional database that included 959 men who received postoperative RT after radical prostatectomy (RP) was analyzed: 19% received adjuvant RT, 81% received salvage RT, 78% were treated to the prostate bed only, and 22% received radiation to the pelvis. Results: The median follow-up time was 55 months. At 5 years, 10% of patients had Grade 2 late GU toxicity and 1% had Grade 3 late GU toxicity, while 4% of patients had Grade 2 late GI toxicity and 0.4% had Grade 3 late GI toxicity. Multivariate analysis demonstrated that adjuvant RT (p = 0.03), androgen deprivation (p < 0.0001), and prostate bed-only RT (p = 0.007) predicted for Grade 2 or higher late GU toxicity. For GI toxicity, although adjuvant RT was significant in the univariate analysis, no significant factors were found in the multivariate analysis. Conclusions: Overall, the number of high-grade toxicities for postoperative RT was low. Therefore, adjuvant and salvage RT can safely be used in the appropriate settings.

Original languageEnglish
Pages (from-to)1417-1423
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume68
Issue number5
DOIs
StatePublished - Aug 1 2007

Keywords

  • Adjuvant
  • Prostate cancer
  • Radiation
  • Salvage
  • Toxicity

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