A Maggio1, D Gabriele2,3, E Garibaldi2, S Bresciani4, E Delmastro2, A Di Dia4, A Miranti4, M Poli4, T Varetto5, M Stasi4, P Gabriele2. 1. Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy. maggio.angelo@gmail.com. 2. Radiotherapy Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy. 3. Division of Radiation Oncology, University of Sassari, Sassari, Italy. 4. Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy. 5. Nuclear Medicine Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy.
Abstract
PURPOSE AND OBJECTIVE: To test the hypothesis that a rectal and bladder preparation protocol is associated with an increase in prostate cancer specific survival (PCSS), clinical disease free survival (CDFS) and biochemical disease free survival (BDFS). PATIENTS AND METHODS: From 1999 to 2012, 1080 prostate cancer (PCa) patients were treated with three-dimensional conformal radiotherapy (3DCRT). Of these patients, 761 were treated with an empty rectum and comfortably full bladder (RBP) preparation protocol, while for 319 patients no rectal/bladder preparation (NRBP) protocol was adopted. RESULTS: Compared with NRBP patients, patients with RBP had significantly higher BDFS (64% vs 48% at 10 years, respectively), CDFS (81% vs 70.5% at 10 years, respectively) and PCSS (95% vs 88% at 10 years, respectively) (log-rank test p < 0.001). Multivariate analysis (MVA) indicated for all treated patients and intermediate high-risk patients that the Gleason score (GS) and the rectal and bladder preparation were the most important prognostic factors for PCSS, CDFS and BDFS. With regard to high- and very high-risk patients, GS, RBP, prostate cancer staging and RT dose were predictors of PCSS, CDFS and BDFS in univariate analysis (UVA). CONCLUSION: We found strong evidence that rectal and bladder preparation significantly decreases biochemical and clinical failures and the probability of death from PCa in patients treated without daily image-guided prostate localization, presumably since patients with RBP are able to maintain a reproducibly empty rectum and comfortably full bladder across the whole treatment compared with NRPB patients.
PURPOSE AND OBJECTIVE: To test the hypothesis that a rectal and bladder preparation protocol is associated with an increase in prostate cancer specific survival (PCSS), clinical disease free survival (CDFS) and biochemical disease free survival (BDFS). PATIENTS AND METHODS: From 1999 to 2012, 1080 prostate cancer (PCa) patients were treated with three-dimensional conformal radiotherapy (3DCRT). Of these patients, 761 were treated with an empty rectum and comfortably full bladder (RBP) preparation protocol, while for 319 patients no rectal/bladder preparation (NRBP) protocol was adopted. RESULTS: Compared with NRBP patients, patients with RBP had significantly higher BDFS (64% vs 48% at 10 years, respectively), CDFS (81% vs 70.5% at 10 years, respectively) and PCSS (95% vs 88% at 10 years, respectively) (log-rank test p < 0.001). Multivariate analysis (MVA) indicated for all treated patients and intermediate high-risk patients that the Gleason score (GS) and the rectal and bladder preparation were the most important prognostic factors for PCSS, CDFS and BDFS. With regard to high- and very high-risk patients, GS, RBP, prostate cancer staging and RT dose were predictors of PCSS, CDFS and BDFS in univariate analysis (UVA). CONCLUSION: We found strong evidence that rectal and bladder preparation significantly decreases biochemical and clinical failures and the probability of death from PCa in patients treated without daily image-guided prostate localization, presumably since patients with RBP are able to maintain a reproducibly empty rectum and comfortably full bladder across the whole treatment compared with NRPB patients.
Authors: Asa Karlsdottir; Ludvig Paul Muren; Tore Wentzel-Larsen; Dag C Johannessen; Svein Andreas Haukaas; Ole Johan Halvorsen; Olav Dahl Journal: Acta Oncol Date: 2009 Impact factor: 4.089
Authors: Peter C Albertsen; James A Hanley; George H Barrows; David F Penson; Pam D H Kowalczyk; M Melinda Sanders; Judith Fine Journal: J Natl Cancer Inst Date: 2005-09-07 Impact factor: 13.506
Authors: M J Zelefsky; Z Fuks; L Happersett; H J Lee; C C Ling; C M Burman; M Hunt; T Wolfe; E S Venkatraman; A Jackson; M Skwarchuk; S A Leibel Journal: Radiother Oncol Date: 2000-06 Impact factor: 6.280
Authors: A Jackson; M W Skwarchuk; M J Zelefsky; D M Cowen; E S Venkatraman; S Levegrun; C M Burman; G J Kutcher; Z Fuks; S A Liebel; C C Ling Journal: Int J Radiat Oncol Biol Phys Date: 2001-03-01 Impact factor: 7.038
Authors: M J Zelefsky; S A Leibel; P B Gaudin; G J Kutcher; N E Fleshner; E S Venkatramen; V E Reuter; W R Fair; C C Ling; Z Fuks Journal: Int J Radiat Oncol Biol Phys Date: 1998-06-01 Impact factor: 7.038
Authors: Domenico Gabriele; Barbara A Jereczek-Fossa; Marco Krengli; Elisabetta Garibaldi; Maria Tessa; Gregorio Moro; Giuseppe Girelli; Pietro Gabriele Journal: Radiat Oncol Date: 2016-02-24 Impact factor: 3.481