To test the hypothesis that a rectal and bladder preparation protocol is associated with an increase in prostate cancer specific survival (PCSS), clinical disease free survival (CDFS) and biochemical disease free survival (BDFS).
From 1999 to 2012, 1080 prostate cancer (PCa) patients were treated with three-dimensional conformal radiotherapy (3DCRT). Of these patients, 761 were treated with an empty rectum and comfortably full bladder (RBP) preparation protocol, while for 319 patients no rectal/bladder preparation (NRBP) protocol was adopted.
Compared with NRBP patients, patients with RBP had significantly higher BDFS (64% vs 48% at 10 years, respectively), CDFS (81% vs 70.5% at 10 years, respectively) and PCSS (95% vs 88% at 10 years, respectively) (log-rank test p < 0.001). Multivariate analysis (MVA) indicated for all treated patients and intermediate high-risk patients that the Gleason score (GS) and the rectal and bladder preparation were the most important prognostic factors for PCSS, CDFS and BDFS. With regard to high- and very high-risk patients, GS, RBP, prostate cancer staging and RT dose were predictors of PCSS, CDFS and BDFS in univariate analysis (UVA).
We found strong evidence that rectal and bladder preparation significantly decreases biochemical and clinical failures and the probability of death from PCa in patients treated without daily image-guided prostate localization, presumably since patients with RBP are able to maintain a reproducibly empty rectum and comfortably full bladder across the whole treatment compared with NRPB patients.
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 2017 Jun 15 [Epub]
A Maggio, D Gabriele, E Garibaldi, S Bresciani, E Delmastro, A Di Dia, A Miranti, M Poli, T Varetto, M Stasi, P Gabriele
Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy. ., Radiotherapy Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy., Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy., Nuclear Medicine Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy.