Urinary outcomes for men with high baseline international prostate symptom scores treated with prostate SBRT Journal Article


Authors: Gorovets, D.; Hopkins, M.; Goldman, D. A.; Levy Abitbol, R.; Zhang, Z.; Kollmeier, M.; McBride, S.; Zelefsky, M. J.
Article Title: Urinary outcomes for men with high baseline international prostate symptom scores treated with prostate SBRT
Abstract: Purpose: There are limited data regarding high-dose stereotactic body radiation therapy (SBRT) for prostate cancer in patients with poor baseline urinary function. The purpose of this study was to evaluate genitourinary (GU) toxicity and changes in patient-reported symptom severity scores after prostate SBRT in men with a high pretreatment International Prostate Symptom Score (IPSS). Methods and Materials: Seven hundred fifty-three patients treated with prostate SBRT at our institution from 2012 to 2019 were identified, of whom 72 consecutive patients with baseline IPSS ≥15 were selected for this study. GU toxicity according to Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and IPSS were prospectively documented at each follow-up visit. Univariable logistic regression was used to evaluate for potential predictors of GU toxicity. Results: Median follow-up in survivors was 26.8 months. The rates of acute grade 2 and 3 GU toxicity were 20.8% and 1.4%, respectively. The rates of late grade 2 and 3 GU toxicity were 37.5% and 5.6%, respectively. The majority of grade 2+ toxicities resolved by last follow-up, and when toxicities were regraded per CTCAE v5.0, there were no longer any grade 3 adverse events. Total IPSS and individual symptom subscores improved over time. Compared with baseline, median total IPSS at 24 ± 6 months was significantly lower (18 vs 12; P < .001) and the proportion of patients with severe scores (IPSS ≥20) decreased from 29.2% to 13.9%. Pretreatment urinary urgency was associated with late grade 2+ GU toxicity (odds ratio, 2.10; 95% confidence interval, 1.33-3.31; P = .001). Conclusions: In men with baseline IPSS ≥15 managed with prostate SBRT, the rate of severe GU toxicity was low and patient-reported symptoms generally improved over time. Thus, high pretreatment IPSS should not deter clinicians from offering prostate SBRT. © 2020 The Author(s)
Journal Title: Advances in Radiation Oncology
Volume: 6
Issue: 1
ISSN: 2452-1094
Publisher: Elsevier Inc.  
Date Published: 2021-01-01
Start Page: 100582
Language: English
DOI: 10.1016/j.adro.2020.09.022
PROVIDER: scopus
PMCID: PMC7897767
PUBMED: 33665486
DOI/URL:
Notes: Article -- Export Date: 1 February 2021 -- Source: Scopus
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MSK Authors
  1. Zhigang Zhang
    392 Zhang
  2. Michael J Zelefsky
    749 Zelefsky
  3. Marisa A Kollmeier
    213 Kollmeier
  4. Debra Alyssa Goldman
    155 Goldman
  5. Sean Matthew McBride
    260 McBride
  6. Margaret F. Hopkins
    10 Hopkins