PURPOSE: To describe the late transient worsening of urinary symptoms ("urinary symptom flare") in 712 consecutive prostate brachytherapy patients, associated predictive factors, association with rectal and urinary toxicity, and the development of erectile dysfunction. METHODS AND MATERIALS: Patients underwent implantation between 1998 and 2003 (median follow-up, 57 months). International Prostate Symptom Score (IPSS), Radiation Therapy Oncology Group (RTOG) toxicity, and erectile function data were prospectively collected. Flare was defined as an increase in IPSS of > or =5 and of > or =8 points greater than the post-treatment nadir. The relationships between the occurrence of flare and the patient, tumor, and treatment characteristics were examined. The Cox proportional hazards method was used to test individual variables and the multivariate models. RESULTS: The incidence of flare was 52% and 30% using the flare definition of an IPSS of > or =5 and > or =8 points greater than the postimplant nadir, respectively. Of the patients with symptoms, 65% had resolution of their symptoms within 6 months and 91% within 1 year. Flares most commonly occurred 16-24 months after implantation. On multivariate analysis, a greater baseline IPSS and greater maximal postimplant IPSS were the predictors of flare, regardless of the flare definition used. Androgen suppression was a predictor for fewer flares (IPSS > or =5). Diabetes and prostate edema predicted for more frequent flares (IPSS >/=8). Patients with flare had a greater incidence of RTOG Grade 3 urinary toxicity and RTOG Grade 2 or greater rectal toxicity. No association was found between erectile dysfunction and the occurrence of flare. CONCLUSION: Urinary symptom flare is a common, transient phenomenon after prostate brachytherapy. A greater baseline IPSS and maximal postimplant IPSS were the strongest predictive factors. Flare was associated with a greater incidence of late RTOG Grade 3 urinary toxicity and greater rate of late RTOG Grade 2 or greater rectal toxicity.
PURPOSE: To describe the late transient worsening of urinary symptoms ("urinary symptom flare") in 712 consecutive prostate brachytherapy patients, associated predictive factors, association with rectal and urinary toxicity, and the development of erectile dysfunction. METHODS AND MATERIALS: Patients underwent implantation between 1998 and 2003 (median follow-up, 57 months). International Prostate Symptom Score (IPSS), Radiation Therapy Oncology Group (RTOG) toxicity, and erectile function data were prospectively collected. Flare was defined as an increase in IPSS of > or =5 and of > or =8 points greater than the post-treatment nadir. The relationships between the occurrence of flare and the patient, tumor, and treatment characteristics were examined. The Cox proportional hazards method was used to test individual variables and the multivariate models. RESULTS: The incidence of flare was 52% and 30% using the flare definition of an IPSS of > or =5 and > or =8 points greater than the postimplant nadir, respectively. Of the patients with symptoms, 65% had resolution of their symptoms within 6 months and 91% within 1 year. Flares most commonly occurred 16-24 months after implantation. On multivariate analysis, a greater baseline IPSS and greater maximal postimplant IPSS were the predictors of flare, regardless of the flare definition used. Androgen suppression was a predictor for fewer flares (IPSS > or =5). Diabetes and prostate edema predicted for more frequent flares (IPSS >/=8). Patients with flare had a greater incidence of RTOG Grade 3 urinary toxicity and RTOG Grade 2 or greater rectal toxicity. No association was found between erectile dysfunction and the occurrence of flare. CONCLUSION: Urinary symptom flare is a common, transient phenomenon after prostate brachytherapy. A greater baseline IPSS and maximal postimplant IPSS were the strongest predictive factors. Flare was associated with a greater incidence of late RTOG Grade 3 urinary toxicity and greater rate of late RTOG Grade 2 or greater rectal toxicity.
Authors: Thomas P Kole; Michael Tong; Binbin Wu; Siyuan Lei; Olusola Obayomi-Davies; Leonard N Chen; Simeng Suy; Anatoly Dritschilo; Ellen Yorke; Sean P Collins Journal: Acta Oncol Date: 2015-05-14 Impact factor: 4.089
Authors: Mira Keyes; Juanita Crook; W James Morris; Gerard Morton; Tom Pickles; Nawaid Usmani; Eric Vigneault Journal: Can Urol Assoc J Date: 2013 Jan-Feb Impact factor: 1.862
Authors: Jennifer A Woo; Leonard N Chen; Aditi Bhagat; Eric K Oermann; Joy S Kim; Rudy Moures; Thomas Yung; Siyuan Lei; Brian T Collins; Deepak Kumar; Simeng Suy; Anatoly Dritschilo; John H Lynch; Sean P Collins Journal: Front Oncol Date: 2014-05-26 Impact factor: 6.244
Authors: Zaker Rana; Robyn A Cyr; Leonard N Chen; Brian S Kim; Rudy A Moures; Thomas M Yung; Siyuan Lei; Brian T Collins; Simeng Suy; Anatoly Dritschilo; John H Lynch; Sean P Collins Journal: Front Oncol Date: 2014-10-21 Impact factor: 6.244
Authors: Leonard N Chen; Simeng Suy; Sunghae Uhm; Eric K Oermann; Andrew W Ju; Viola Chen; Heather N Hanscom; Sarah Laing; Joy S Kim; Siyuan Lei; Gerald P Batipps; Keith Kowalczyk; Gaurav Bandi; John Pahira; Kevin G McGeagh; Brian T Collins; Pranay Krishnan; Nancy A Dawson; Kathryn L Taylor; Anatoly Dritschilo; John H Lynch; Sean P Collins Journal: Radiat Oncol Date: 2013-03-13 Impact factor: 3.481
Authors: Grant K Hunter; Chandana A Reddy; Eric A Klein; Patrick Kupelian; Kenneth Angermeier; James Ulchaker; Nabil Chehade; Andrew Altman; Jay P Ciezki Journal: Prostate Cancer Date: 2012-04-11
Authors: Onita Bhattasali; Leonard N Chen; Jennifer Woo; Jee-Won Park; Joy S Kim; Rudy Moures; Thomas Yung; Siyuan Lei; Brian T Collins; Keith Kowalczyk; Simeng Suy; Anatoly Dritschilo; John H Lynch; Sean P Collins Journal: Radiat Oncol Date: 2014-02-11 Impact factor: 3.481