AI Article Synopsis
- The study evaluated how the dose of radiation to the bladder neck affects urinary problems reported by patients after prostate brachytherapy.
- Patients were analyzed based on their bladder neck dose relative to the total prescription dose, with those receiving more than 70% experiencing worse urinary symptoms.
- Overall, the findings suggest that limiting the bladder neck dose to less than 70% can minimize urinary side effects while maintaining effective disease control over a follow-up period of nearly 5 years.
Article Abstract
Background: We sought to assess the impact of bladder neck dose (BND) on patient reported urinary toxicity, and feasibility of relative urethral sparing technique in prostate brachytherapy (PB).
Methods And Materials: We retrospectively identified bladder neck as a point dose on post-implant CT scans in patients treated with Cs PB. Urinary symptoms were assessed through EPIC questionnaires. Patient cohorts were identified based on mean BND as a percentage of prescription dose with toxicity assessment at each time point.
Results: In our cohort of 542 patients, BND was associated with clinically significant acute urinary symptoms and chronic symptoms, as patients receiving >70% of the prescription dose had significantly worse overall EPIC scores than patients receiving ≤70% of prescription dose. There was no difference in bDFS between patients receiving BND ≤70% (96% bDFS) and >70% (94% bDFS) at a median follow up of 57 months.
Conclusions: BND has a significant impact on both acute and chronic urinary symptoms, with reduced symptoms reported with BND <70% of prescription dose. With a median follow up of 4.7 years, excellent bDFS has thus far been achieved with relative urethral and bladder neck sparing. Utilizing this constraint should improve urinary symptoms without impacting disease control.
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| http://dx.doi.org/10.1016/j.brachy.2023.08.009 | DOI Listing |
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