Radiotherapy (RT) for prostate cancer is associated with distinct treatment-related complications such as cystitis and urinary stricture that can occur many years after the fact, according to study results presented at the American Urological Association (AUA) 2021 Virtual Experience.
Investigators sought to determine the incidence of complications associated with primary RT using the University of California San Francisco Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a nationwide, longitudinal observational study that includes 43 primarily community-based urology practices in the United States.
Men who were diagnosed with prostate cancer from 1994 to 2017 and treated with primary RT were included in the study. The researchers searched for patient-reported and International Classification of Diseases, 9th revision/Common Procedural Terminology codes classified by the diagnosis and management of radiation cystitis, fistula, ureteral injury, and urethral stricture disease.
A total of 15,335 men with a diagnosis of prostate cancer were identified — 2170 (14.2%) had primary RT. Among the participants, 442 (66%) were aged 50 to 65 years, and 76% were White. Also, 361 men (56%) had clinical T2 stage cancer and 289 patients (46%) had a National Comprehensive Cancer Network intermediate risk.
The median follow-up was 7.7 years (interquartile range [IQR], 4.2-12.4), and 72% were followed for longer than 5 years after RT. Among those who had primary RT, 387 men (17.8%) had a complication.
Following primary RT, the most frequent complication among the men was cystitis (173, 8%) after a median of 3.5 years (IQR, 1.4-7.8), urinary stricture (104, 4.8%) after a median of 3.3 years (IQR, 1.8-7.3), fistula (73, 3.4%) after a median of 4.0 years (IQR, 1.3-7.6), and ureter injury (7, 0.3%) after a median of 8.1 years (IQR, 7.8-10.2). In addition, 30 patients (1.4%) had another, unspecified complication after a median of 5.5 years (IQR, 1.6-9.8).
Lonergan PE, Baskin A, Greenberg SA, et al. The long-term incidence of complications associated with radiotherapy for prostate cancer. Presented at: AUA2021 Virtual Experience held September 10-13, 2021. MP03-13.