MEDLINE Journals

    The impact of radiation dose to the urethra on brachytherapy-related dysuria.

    Authors
    Merrick GS, Butler WM, Wallner KE, et al. 
    Institution

    Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV 26003-6300, USA. gmerrick@wheelinghospital.com

    Source
    Brachytherapy 2005; 4(1) :45-50.
    Abstract

    To determine the effect of urethral dose on dysuria after permanent prostate brachytherapy.One hundred eight patients without a preimplant history of a transurethral resection underwent brachytherapy on one of two prospective randomized trials for clinical T1c-T2c (2002 AJCC) prostate cancer. Urethral dose was stratified into cohorts of <150% and 150% minimum peripheral dose (mPD) respectively. No patient received prophylactic alpha blockers. The median follow-up was 27.4 months. Dysuria was defined as pain and/or burning on urination and was evaluated on a 0-10 scale. Normalization of dysuria was defined as a return to within 1 point of baseline. Dysuria surveys were obtained before brachytherapy and at 1, 3, 6, and 12 months after implantation. Clinical, treatment, and dosimetric parameters evaluated included urethral dose, age, preimplant International Prostate Symptom Score (I-PSS), ultrasound volume, hormonal status, supplemental XRT, isotope, V(100/200), D(90), the maximum post-implant I-PSS, and the time to I-PSS resolution.The incidence of dysuria peaked at 85% one month after brachytherapy with subsequent resolution over time. Radiation dose to the urethra (stratified into cohorts of <150%, and 150% mPD) was not a significant predictor of prevalence, severity, or resolution of dysuria. In a multivariate analysis, isotope predicted for dysuria normalization while preimplant I-PSS and D(90) predicted for maximum dysuria; however, the area under the ROC curve and the Pearson correlation coefficient revealed weak correlations.Dysuria is common after brachytherapy, but typically minimal in severity. Urethral doses did not predict for either dysuria severity or normalization. Although preimplant I-PSS was the strongest predictor of maximum dysuria and isotope the best predictor for dysuria normalization, robust predictors for brachytherapy-related dysuria were not identified.

    Mesh
    Aged
    Brachytherapy
    Humans
    Male
    Prospective Studies
    Prostatic Neoplasms
    Radiotherapy Dosage
    Urethra
    Urination Disorders
    Language

    eng

    Pub Type(s)
    Clinical Trial Journal Article Randomized Controlled Trial
    PubMed ID

    15737906

    Content Manager
    Related Content

    Dysuria after permanent prostate brachytherapy.

    Brachytherapy-related dysuria.

    Detailed urethral dosimetry in the evaluation of prostate brachytherapy-related urinary morbidity.

    The effect of hormonal manipulation on urinary function following permanent prostate brachytherapy.

    The influence of isotope and prostate volume on urinary morbidity after prostate brachytherapy.

    Temporal resolution of urinary morbidity following prostate brachytherapy.

    Factors predicting for urinary incontinence after prostate brachytherapy.

    Prophylactic versus therapeutic alpha-blockers after permanent prostate brachytherapy.