Prostate IMRT reduces gastrointestinal problems compared with CRT
MedWire News: Men with non-metastatic prostate cancer can expect fewer serious bowel complications after treatment with intensity-modulated radiation therapy (IMRT) than after three-dimensional conformal radiotherapy (CRT), report researchers.
"While radiotherapy is highly effective in treating prostate cancer, many men live with the gastrointestinal, urinary, and sexual side effects of treatment for many years," said lead study author Justin Bekelman (University of Pennsylvania, Philadelphia, USA).
"Minimizing these side effects and improving men's quality of life after prostate cancer treatment is incredibly important," he added.
Bekelman and colleagues will present the results of their study at the upcoming 52nd Annual Meeting of the American Society for Radiation Oncology in San Diego, California.
The group analyzed data for 5845 IMRT-treated and 6753 CRT-treated prostate cancer patients aged 65 years or older from the Surveillance, Epidemiology, and End Results database. The men were diagnosed between 2002 and 2004 and followed-up through 2006.
Bekelman et al identified and compared the incidence of bowel, urinary, and erectile complications between the two treatment groups using Medicare claims, which only included serious cases that required a surgical procedure or hospitalization.
The overall 24-month cumulative incidence of bowel complications was higher for CRT-treated men compared with IMRT-treated men, at 22.5% versus 18.8%. The corresponding rates of proctitis/hemorrhage were 4.5% versus 3.5%.
The researchers observed no significant differences in the incidence of urinary and sexual side effects (for example incidence of erectile dysfunction was low) between the treatment groups. However, they point out that their data only came from patients whose complications required an invasive surgical intervention, which is less commonly with urinary and sexual side effects.
Multivariate analysis, adjusted for potential confounders including age, ethnicity, clinical T-stage, Gleason score, and area median income, revealed that IMRT reduced the incidence of bowel complications and proctitis/hemorrhage by a significant 14% and 22%, respectively, compared with CRT.
Conversely, the associations between IMRT and urinary and erectile complications compared with CRT were nonsignificant.
"Our study offers important evidence to patients and their doctors that IMRT is associated with fewer gastrointestinal problems after treatment," concluded Bekelman.
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By Sarah Guy