PMID- 32719744
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 10
DP  - 2020
TI  - Stereotactic Body Radiation Therapy (SBRT) for Prostate Cancer in Men With a High 
      Baseline International Prostate Symptom Score (IPSS >/= 15).
PG  - 1060
LID - 10.3389/fonc.2020.01060 [doi]
LID - 1060
AB  - Background: Patients with a high pretreatment IPSS may have higher rates of late 
      urinary morbidity after radiation therapy for prostate cancer (1). Stereotactic 
      body radiation therapy (SBRT) delivers fewer high-dose fractions of radiation, 
      which may be radiobiologically favorable to the conventional low-dose external 
      beam fractions. The urinary toxicity associated with SBRT, however, remains 
      unclear in patients with a high IPSS (1). We report our experience using SBRT for 
      localized prostate cancer in patients with pretreatment IPSS >/= 15. Methods: 
      Localized prostate cancer patients with a pre-treatment IPSS >/= 15 treated with 
      SBRT at Georgetown University Hospital from 2009 to 2016 were included in this 
      retrospective review of prospectively collected data. These patients were treated 
      to 35-36.25 Gy in five fractions delivered via CyberKnife (Accuray Inc., 
      Sunnyvale, CA). Urinary toxicity was assessed using the Common Terminology 
      Criteria for Adverse Events version 4.0 (CTCAE v4). Urinary quality of life was 
      assessed using validated questionnaires (IPSS and EPIC-26). Results: 53 patients 
      at a median age of 71 years (range 57-89 years) received SBRT with a minimum 
      follow up of 3 years. The median prostate size was 37 cm(3) (range 12-100 cm(3)) 
      and 30.2% patients received ADT. The 3-years incidence rate of Grade 3 urinary 
      toxicity was 7.5% with median time to toxicity of 2.9 years. There were no Grade 
      4 or 5 toxicities. A mean baseline IPSS score of 19.8 significantly decreased to 
      12.9 at 3 months post-SBRT (p = 0.002) and remained stable at 36 months (13.7). A 
      mean baseline EPIC-26 obstructive/irritative score of 64.1 significantly improved 
      to 80.2 at 3 months (p = 0.002). This improvement was maintained to 36 months. 
      There was no significant change from the mean baseline EPIC-26 urinary 
      incontinence score at any point during follow up. Conclusions: SBRT for 
      clinically localized prostate cancer was well-tolerated in men with baseline IPSS 
      >/= 15 (1). Grade 3 toxicities occurred but resolved with time. Our data suggest 
      that poor baseline urinary function does not worsen following SBRT and may even 
      improve. High baseline IPSS score should not be considered a contraindication to 
      SBRT.
CI  - Copyright (c) 2020 Aghdam, Pepin, Buchberger, Hirshberg, Lei, Ayoob, Danner, Yung, 
      Kumar, Collins, Lynch, Kataria, Suy and Collins.
FAU - Aghdam, Nima
AU  - Aghdam N
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Pepin, Abigail
AU  - Pepin A
AD  - George Washington University, School of Medicine and Health Sciences, Washington, 
      DC, United States.
FAU - Buchberger, David
AU  - Buchberger D
AD  - University of Cincinnati College of Medicine, Cincinnati, OH, United States.
FAU - Hirshberg, Jason
AU  - Hirshberg J
AD  - Arizona College of Osteopathic Medicine, Glendale, AZ, United States.
FAU - Lei, Siyuan
AU  - Lei S
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Ayoob, Marilyn
AU  - Ayoob M
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Danner, Malika
AU  - Danner M
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Yung, Thomas
AU  - Yung T
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Kumar, Deepak
AU  - Kumar D
AD  - Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina 
      Central University, Durham, NC, United States.
FAU - Collins, Brian T
AU  - Collins BT
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Lynch, John
AU  - Lynch J
AD  - Department of Urology, Georgetown University Hospital, Washington, DC, United 
      States.
FAU - Kataria, Shaan
AU  - Kataria S
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Suy, Simeng
AU  - Suy S
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
FAU - Collins, Sean P
AU  - Collins SP
AD  - Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, 
      United States.
LA  - eng
GR  - R01 MD012767/MD/NIMHD NIH HHS/United States
PT  - Journal Article
DEP - 20200703
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC7350884
OTO - NOTNLM
OT  - EPIC
OT  - IPSS
OT  - SBRT
OT  - common toxicity criteria (CTC)
OT  - cyberknife
OT  - prostate cancer
OT  - quality of life
EDAT- 2020/07/29 06:00
MHDA- 2020/07/29 06:01
PMCR- 2020/01/01
CRDT- 2020/07/29 06:00
PHST- 2020/02/16 00:00 [received]
PHST- 2020/05/28 00:00 [accepted]
PHST- 2020/07/29 06:00 [entrez]
PHST- 2020/07/29 06:00 [pubmed]
PHST- 2020/07/29 06:01 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2020.01060 [doi]
PST - epublish
SO  - Front Oncol. 2020 Jul 3;10:1060. doi: 10.3389/fonc.2020.01060. eCollection 2020.