J Urol Oncol.  2024 Mar;22(1):21-28. 10.22465/juo.244600080004.

High-Grade Late Urinary Toxicity Following Salvage Radiotherapy After Radical Prostatectomy: A Retrospective Cohort Study

• Choi SK
• Kim M
• Lee SM
• Song C
• Hong JH
• Kim CS
• Ahn H

• KMID: 2553941
• DOI: http://doi.org/10.22465/juo.244600080004

Abstract

Purpose
To find out the incidence and predictors for late high-grade genitourinary (GU) toxicity following salvage radiotherapy (SRT), we investigated the consecutive patients who were treated with SRT after radical prostatectomy.
Materials and Methods
Patients who underwent SRT for biochemical recurrence after radical prostatectomy were reviewed. The incidence of GU toxicity was assessed and risk factors for grade ≥2 and ≥3 GU toxicity were evaluated. The STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guided the reporting of this study.
Results
Among the total of 217 patients, 88 patients (40.5%) showed late grade ≥2 GU toxicity. The incidence of late grade ≥3 GU toxicity was 11.5%. The presence of grade ≥2 baseline GU dysfunction (hazard ratio [HR], 6.097; 95% confidence interval [CI], 3.280–11.333; p<0.001) and short interval (<1 year) from surgery to SRT (HR, 1.994; 95% CI, 1.182–3.365; p=0.01) were associated with late grade ≥2 GU toxicity. A short interval from surgery to SRT was an independent predictor of late grade ≥3 GU toxicity (HR, 2.975; 95% CI, 1.135–7.794; p=0.027).
Conclusions
The incidence of late high-grade GU toxicity was not uncommon after SRT. Thus, care should be taken when we consider SRT in patients with baseline urinary dysfunction and a short interval from surgery to SRT, to determine an optimal treatment strategy with balancing quality of life and oncologic outcome of patients.

Keyword

Prostatic neoplasms; Radical prostatectomy; Salvage radiotherapy; Urinary toxicity