Assessment of lower urinary symptom flare with overactive bladder symptom score and International Prostate Symptom Score in patients treated with iodine-125 implant brachytherapy: long-term follow-up experience at a single institute

BMC Urology

Research Article

Noboru Konishi¹  Tomomi Fujii¹  Masatoshi Hasegawa²  Isao Asakawa²  Katsuya Aoki³  Nobumichi Tanaka³  Takeshi Inoue³  Kazumasa Torimoto³  Yosuke Morizawa³  Shunta Hori³  Makito Miyake³  Yasushi Nakai³  Kiyohide Fujimoto³  Satoshi Anai³  Yoshihiro Tatsumi⁴ 

[1] Department of Pathology, Nara Medical University, Nara, Japan;Department of Radiation Oncology, Nara Medical University, Nara, Japan;Department of Urology, Nara Medical University, 840 Shijo-cho, 634-8522, Nara, Japan;Department of Urology, Nara Medical University, 840 Shijo-cho, 634-8522, Nara, Japan;Department of Pathology, Nara Medical University, Nara, Japan;

关键词: Prostate cancer;    Brachytherapy;    International Prostate Symptom Score;    Overactive bladder symptom score;    Biologically effective dose;    PSA bounce;   

DOI  :  10.1186/s12894-017-0251-1

 received in 2016-08-28, accepted in 2017-08-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to evaluate the combined use of the overactive bladder symptom score (OABSS) and International Prostate Symptom Score (IPSS) as an assessment tool for urinary symptom flare after iodine-125 (125I) implant brachytherapy. The association between urinary symptom flare and prostate-specific antigen (PSA) bounce was investigated.MethodsChanges in the IPSS and OABSS were prospectively recorded in 355 patients who underwent seed implantation. The percentage distribution of patients according to the difference between the flare peak and post-implant nadir was plotted to define significant increases in the scores. The clinicopathologic characteristics, treatment parameters, and post-implant dosimetric parameters were compared between the non-flare and flare groups. PSA bounce was defined as an elevation of ≥0.1 ng/mL or ≥0.4 ng/mL compared to the previous lowest value, followed by a decrease to a level at or below the pre-bounce value.ResultsA clinically significant increase required an IPSS increase of at least 12 points and an OABSS increase of at least 6 points based on a time-course analysis of total scores and the QOL index. Assessment only by IPSS failed to detect 40 patients (11%) who had urinary symptom flare according to the OABSS. Univariate and multivariate analyses revealed that patients treated with higher biologically effective doses and those without diabetes mellitus had higher risks of urinary flare. There was no statistical correlation between the incidence and time of urinary symptom flare onset and that of a PSA bounce.ConclusionsTo our knowledge, this is the first report to prove the clinical potential of the OABSS as an assessment tool for urinary symptom flare after seed implantation. Our findings showed that persistent lower urinary tract symptoms after seed implantation were attributed to storage rather than to voiding issues. We believe that assessment with the OABSS combined with the IPSS would aid in decision-making in terms of timing, selection of a treatment intervention, and assessment of the outcome.

【 授权许可】

CC BY   
© The Author(s). 2017