Login to Access Video or Poster Abstract: MP05-03
Sources of Funding: none

Introduction

Limited data exist regarding urinary continence after post-radical prostatectomy (RP) intensity modulated radiation therapy (IMRT) and whether IMRT influences urinary continence or interfere with the recovery from RP when given early.

Methods

118 men were treated with curative-intent RT after RP. Forty-three men (36%) received adjuvant RT (13%) and early salvage (23%) within the 1st year from surgery and 75 men (64%) received late salvage RT (>1year from RP). Quality of life measures were prospectively assessed using the Expanded Prostate Cancer Index Composite (EPIC-26) by patients at baseline and at follow-up times. Each group (early and late RT) was compared to a control group from our prospective collected RP cohort that did not had RT based on age at RP, BMI, pre-operative incontinence scores and post-operative incontinence scores and pad usage. The control group included 248 men with a median follow-up time of 44 months. Due to differences in stage of the RP and RT cohorts, it was not possible to control for sparing of the neurovascular bundles. Endpoints are pad usage and incontinence score.

Results

With a median follow-up time of 60m, in men treated with IMRT, 29 patients (25%) deteriorated in pad usage, 14 (12%) improved and 75 (63%) were stable. Deterioration in continence was correlated with poor baseline incontinence scores (p<0.001) and with pre-RT number of pad usage per day. Of the patients that scores 100 in the incontinence score, only 3% deteriorated in continence. _x000D_ In the early (<1 year) RT group, mean incontinence score improved from 57 to 72 (p<0.01) and in the late RT group, mean incontinence score deteriorated from 80 to 69 (p<0.001) and was associated with a 13% deterioration in pad-free rates (p<0.05). _x000D_ Comparison to the control group showed a 12% and 5% differences in pad-free status in the late RT group and the early RT group respectively. Comparison of the entire cohort to the control group showed a 10% higher pad free rate in the control group - 74% Vs. 64% (p<0.001) (figure 1) _x000D_

Conclusions

Late salvage RT caused 12% deterioration in pad-free status._x000D_ With the limitations of our control group, comparison to the cohort group showed 10% lower pad free rates after post prostatectomy RT. _x000D_ Deterioration in continence is strongly associated with the baseline urinary function._x000D_

Funding

none