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Vol. 42. Issue 4.
Pages 256-261 (May 2018)
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Vol. 42. Issue 4.
Pages 256-261 (May 2018)
Special article
Cumulative incidence and predictive factors of radiation cystitis in patients with localized prostate cancer
La incidencia acumulada y los factores predictivos de la cistitis rádica en pacientes con cáncer de próstata localizado
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D. Afonso-Joãoa,
Corresponding author
davidaj6@hotmail.com

Corresponding author.
, L. Pacheco-Figueiredob,c, T. Antunes-Lopesa,c, L.A. Morgadoa,c, V. Azevedoa,c, L. Vendeiraa,d, J. Silvaa,c,e, C. Martins-Silvaa,c,e
a Faculty of Medicine of Porto University, Centro Hospitalar São João, Porto, Portugal
b Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
c Department of Urology, Centro Hospitalar São João, Porto, Portugal
d Department of Radiation Oncology, Centro Hospitalar São João, Porto, Portugal
e i3S, Instituto de Investigação e Inovação em Saúde, Porto University, Porto, Portugal
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Table 1. Patient characteristics.
Table 2. Potential predictive factors of radiation cystitis (RC).
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Abstract
Purpose

To determine the cumulative incidence of overall and severe radiation cystitis in a high volume cohort of patients and to investigate its potential predictive factors.

Methods

We have performed a retrospective analysis of clinical data from patients diagnosed with localized prostate cancer and treated with radiotherapy at our institution (June 2005–January 2013), and quantified the cumulative incidence of radiation cystitis. Cox regression analysis and Kaplan–Meier curves were computed to evaluate the determinants of radiation cystitis.

Results

Data from 783 patients was retrieved (557 treated with primary radiotherapy, 188 with adjuvant and 38 with salvage). Median follow-up time was 49 months (P25–P75: 31.8–69.3). At 5 years of follow-up, cumulative incidence of overall and severe radiation cystitis was 9.1 and 1.6%, respectively. No association was found between the incidence of radiation cystitis and age, tumor T stage, baseline PSA level, Gleason score, D’Amico risk classification, radiotherapy setting (primary versus adjuvant versus salvage) or radiation dose applied.

Conclusions

Within our cohort, radiation cystitis is an uncommon complication of prostatic radiotherapy treatment, and severe cases requiring hospitalization are even more infrequent. We found no association between tumor characteristics, radiotherapy setting or radiation dose and the cumulative incidence of radiation cystitis.

Keywords:
Cystitis
Hematuria
Prostate cancer
Radiotherapy
Survival rate
Resumen
Objetivo

Determinar la incidencia acumulada de la cistitis rádica y la cistitis rádica severa en una cohorte de pacientes de alto volumen e investigar sus potenciales factores predictivos.

Métodos

Hemos realizado un análisis retrospectivo de los datos clínicos de pacientes diagnosticados con cáncer de próstata localizado y tratados con radioterapia en nuestra institución (junio 2005-enero 2013), y cuantificado la incidencia acumulada de cistitis rádica. El análisis de regresión de Cox y las curvas de Kaplan-Meier se calcularon para evaluar los determinantes de la cistitis por radiación.

Resultados

Se utilizaron datos de 783 pacientes (557 tratados con radioterapia primaria, 188 con adyuvante y 38 con rescate). El tiempo medio de seguimiento fue de 49 meses (P25-P75: 31,8-69,3). A los 5 años de seguimiento, la incidencia acumulada de cistitis rádica y cistitis rádica severa fue de 9,1 y 1,6%, respectivamente. No se encontró asociación entre la incidencia de cistitis rádica y la edad, el estadio T tumoral, el nivel de PSA basal, la puntuación de Gleason, la clasificación de riesgo de D’Amico, el ajuste de radioterapia (primario frente a adyuvante frente a rescate) o la dosis de radiación aplicada.

Conclusiones

Dentro de nuestra cohorte, la cistitis rádica es una complicación poco frecuente del tratamiento de radioterapia prostática y los casos graves que requieren hospitalización son aún más infrecuentes. No se encontró asociación entre las características del tumor, el ajuste de la radioterapia o la dosis de radiación y la incidencia acumulada de cistitis rádica.

Palabras clave:
Cistitis
Hematuria
Cáncer de próstata
Radioterapia
Tasa de supervivencia

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