Obstructive urination problems after high-dose-rate brachytherapy boost treatment for prostate cancer are avoidable
| Feb 16, 2016
About this article
Article Category: Research Article
Published Online: Feb 16, 2016
Page range: 94 - 103
Received: Oct 15, 2014
Accepted: Jan 20, 2015
DOI: https://doi.org/10.1515/raon-2015-0010
© 2016 Radiol Oncol
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Results of univariate logistic regression analysis of association between deterioration of obstructive urination problems and treatment factors in Ljubljana Institute of Oncology study of late toxicity after high-dose-rate brachytherapy boost treatment for prostate cancer
| Risk factor | Ntot | Ndet/Ncat (%) | OR | 95 % C.I. limits for OR | p-value | ||
|---|---|---|---|---|---|---|---|
| Lower | Upper | ||||||
| Nimplanted needles | 71 | 0.89 | 0.71 | 1.11 | 0.305 | ||
| Planning imaging | CT | 71 | 3/25 (12.0%) | 1.00 | |||
| MRI | 10/46 (21.7%) | 2.04 | 0.51 | 8.22 | 0.317 | ||
| Ninterventions | 1 | 71 | 10/63 (15.9%) | 1.00 | |||
| 2+ | 3/8 (37.5%) | 3.18 | 0.65 | 15.48 | 0.152 | ||
| PTV1 (ml) | 70 | 1.03 | 0.99 | 1.07 | 0.149 | ||
| D100PTV1 (Gy) | 71 | 1.08 | 0.76 | 1.53 | 0.656 | ||
| D90PTV1 (Gy) | 71 | 0.93 | 0.68 | 1.28 | 0.673 | ||
| D100PTV2 (Gy) | 70 | 0.99 | 0.75 | 1.31 | 0.941 | ||
| Vurethra (ml) | 70 | 1.22 | 0.55 | 2.74 | 0.626 | ||
| D-MEANurethra (Gy) | 70 | 1.06 | 0.84 | 1.35 | 0.629 | ||
| D90urethra volume (Gy) | 71 | 1.18 | 0.95 | 1.47 | 0.145 | ||
| D10urethra volume (Gy) | 70 | 1.07 | 0.87 | 1.31 | 0.521 | ||
| D1urethra volume (Gy) | 71 | 1.03 | 0.86 | 1.22 | 0.780 | ||
| Androgen deprivation | < 12 months | 69 | 2/9 (22.2%) | 1.00 | |||
| ≥ 12 months | 11/60 (18.3%) | 0.79 | 0.14 | 4.31 | 0.781 | ||
Results of univariate logistic regression analysis of association between deterioration of obstructive urination problems and patients’ characteristics in Ljubljana Institute of Oncology study of late toxicity after high-dose-rate brachytherapy boost treatment for prostate cancer
| Risk factor | Ntot | Ndet/Ncat (%) | OR | 95 % C.I. limits for OR | p-value | ||
|---|---|---|---|---|---|---|---|
| Lower | Upper | ||||||
| Age | 70 | 1.05 | 0.94 | 1.17 | 0.372 | ||
| Hypertension | No | 69 | 5/32 (15.6%) | 1.00 | |||
| Yes | 7/37 (18.9%) | 1.26 | 0.36 | 4.44 | 0.719 | ||
| Diabetes | No | 68 | 12/62 (19.4%) | NA | |||
| Yes | 0/6 (0.0%) | NA | NA | NA | 0.581* | ||
| Hyperlipidemia | No | 68 | 8/52 (15.4%) | 1.00 | |||
| Yes | 4/16 (25.0%) | 1.83 | 0.47 | 7.14 | 0.382 | ||
| CVI | No | 69 | 10/62 (16.1%) | 1.00 | |||
| Yes | 2/7 (28.6%) | 2.08 | 0.35 | 12.26 | 0.418 | ||
| Coronary insufficiency | No | 69 | 8/54 (14.8%) | 1.00 | |||
| Yes | 4/15 (26.7) | 2.09 | 0.53 | 8.22 | 0.291 | ||
| Anticoagulation treatment | No | 69 | 6/52 (11.5%) | 1.00 | |||
| Yes | 6/17 (35.5%) | 4.18 | 1.13 | 15.48 | 0.032 | ||
Results of multivariate logistic regression analysis of association between deterioration of obstructive urination problems and selected treatment factors and patients’ characteristics in Ljubljana Institute of Oncology study of late toxicity after high-dose-rate brachytherapy boost treatment for prostate cancer (N = 68)
| Risk factor | OR | 95% C.I. limits for OR | p | ||
|---|---|---|---|---|---|
| lower | upper | ||||
| PTV1 (ml) | 1.02 | 0.98 | 1.07 | 0.292 | |
| D90urethra volume (Gy) | 1.23 | 0.96 | 1.57 | 0.099 | |
| Anticoagulation treatment | No | 1.00 | |||
| Yes | 4.86 | 1.21 | 19.61 | 0.026 | |
Characteristics of dosimetric parameters of high-dose-rate brachytherapy in Ljubljana Institute of Oncology study of late toxicity after high-dose-rate brachytherapy boost treatment for prostate cancer
| Dosimetric parameter | Minimum | Maximum | Mean±SD |
|---|---|---|---|
| PTV1 | 18 ml | 95 ml | 37.6 |
| D100PTV1 | 8.3 Gy | 17.1 Gy | 11.8 |
| D90PTV1 | 13.4 Gy | 24.6 Gy | 19.2 |
| D100PTV2 | 12.8 Gy | 23.7 Gy | 17.3 |
| Vurethra | 1.2 ml | 4.0 ml | 1.9 |
| D-MEANurethra | 14.4 Gy | 26.1 Gy | 19.0 |
| D90urethra volume | 7.5 Gy | 18.9 Gy | 13.2 |
| D10urethra volume | 17.8 Gy | 31.1 Gy | 23.1 |
| D1urethra volume | 17.3 Gy | 36.0 Gy | 24.5 |
Questions addressing obstructive urination problems in Ljubljana Institute of Oncology questionnaire about adverse health effects of radiation therapy
| Question | Possible answers |
|---|---|
| Did you have a sensation of not emptying your bladder in the previous month | Yes/No |
| Did you find stopping and starting again several times when you urinated in the previous month | Yes/No |
| Did you have weak urinary stream in the previous month | Yes/No |
| Did you have to strain to start urination in the previous month | Yes/No |
| Occasionally | |
| At least once a week | |
| If you had any of the problems, how often did they occur | Daily |
| At every urination | |
| No problem | |
| Very small problem | |
| How big were these problems for you | Small problem |
| Moderate problem | |
| Big problem | |
| Did you have to get urinary catheter in the last half of the year | Yes/No |
| Were you operated because of the mentioned problems | Yes/No |
| Did you still have urinary catheter | Yes/No |
Prevalence rates of alteration of obstructive urination problems in Ljubljana Institute of Oncology study of late toxicity after high-dose-rate brachytherapy boost treatment for prostate cancer
| Year of follow-up | N | Major improvement | Minor improvement | No change | Minor deterioration | Major deterioration |
|---|---|---|---|---|---|---|
| 2nd year | 80 | 1 (1.3%) | 10 (12.5%) | 57 (71.3%) | 12 (15.0%) | 0 (0%) |
| 3rd year | 71 | 1 (1.4%) | 11 (15.5%) | 51 (71.8%) | 8 (11.3%) | 0 (0%) |
| 4th year | 45 | 2 (4.4%) | 7 (15.6%) | 31 (68.9%) | 4 (8.9%) | 1 (2.2%) |
| 5th year | 25 | 0 (0%) | 6 (24.0%) | 16 (64.0%) | 3 (12.0%) | 0 (0%) |