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Longitudinal Analysis of Genitourinary and Bowel Symptoms in Prostate Cancer Patients Following Brachytherapy

Eckman, Mark H., MD*; Ying, Jun, PhD; Hertzfeld, Kara, MD; Kumar, Nitin, MS; Barrett, William, MD

American Journal of Clinical Oncology: February 2010 - Volume 33 - Issue 1 - p 1-10
doi: 10.1097/COC.0b013e31819cd364
Original Articles: Genitourinary
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Objectives: Multiple options with similar cure rates exist for men with localized adenocarcinoma of the prostate. Therefore, treatment-related morbidity is a major consideration for treatment selection. We present a descriptive, longitudinal analysis of genitourinary and bowel symptoms following treatment in a brachytherapy registry at the University of Cincinnati.

Methods: Between 1995 and 2007, 394 consecutive patients with newly diagnosed early stage prostate cancer underwent radioactive 125I seed implantation. Patients were followed for an average of 5.0 ± 3.1 years. Follow-up data regarding genitourinary and bowel symptoms and clinical/biochemical evidence of cancer recurrence were collected during posttreatment visits.

Results: Forty percent of men developed urinary obstructive symptoms, generally within the first 3 to 6 months following brachytherapy. These symptoms resolved in a large proportion of men. Impaired potency occurred in 15% of men by 6 months and in more than 40% of men by 60 months. Bowel symptoms were less common and had a slower onset.

Conclusion: Symptoms following brachytherapy each have their own temporal pattern for development and resolution. These patterns are well explained by the underlying pathophysiology of therapeutic radiation injury and healing. Men and their partners can use this information to guide and inform treatment decisions.

From the *Division of General Internal Medicine, Department of Medicine, and Center for Clinical Effectiveness, Cincinnati, Ohio; and Departments of †Public Health Sciences and ‡Radiation Oncology, University of Cincinnati, Cincinnati, Ohio.

Supported by National Institute of Diabetes and Digestive and Kidney Diseases (K23 DK075599), National Heart, Lung, and Blood Institute (K30 HL078581-01), Foundation for Informed Medical Decision Making, and an internal grant from the University of Cincinnati Foundation (to M.H.E.).

Reprints: Mark H. Eckman, MD, University of Cincinnati Medical Center, PO Box 670535, Cincinnati, OH 45267-0535. E-mail: mark.eckman@uc.edu.

© 2010 Lippincott Williams & Wilkins, Inc.