TOPLINE:

In an Italian registry-based study of men with localized prostate cancer who sought urgent medical attention for genitourinary side effects attributable to radiotherapy (RT), more than 40% developed more severe (grade 3-5) complications. From RT completion, hospitalization-free survival declined from 86% at 1 year to 42% at 5 years, and the percentage of patients who did not need major surgery to manage RT-related complications decreased from 81% to 66% during this time.

METHODOLOGY:

• In the prospective IRRADIaTE registry study, researchers explored the rates of late genitourinary complications in 321 patients who presented urgently for urinary issues after prostate/prostate bed RT for localized prostate cancer.
• Overall, 160 (50%) patients received RT as primary treatment and 161 (50%) received adjuvant or salvage RT following radical prostatectomy.
• Researchers tracked patients requiring hospitalization or invasive management. Complications related to RT were recorded and classified according to the Common Terminology Criteria for Adverse Events, with grades 3-5 considered severe or life-threatening.
• Primary endpoints were cumulative incidence of grade 3-5 events with death as a competing risk and hospitalization-free survival from RT completion.

TAKEAWAY:

• At the time of hospital admission, 43% of patients presented with grade 3-5 genitourinary toxicity.
• Hospitalization-free survival rates declined from 86% at 12 months to 42% at 60 months.
• Researchers reported a significantly higher cumulative incidence of severe events in the primary RT group compared with the postoperative RT group.
• The percentage of patients who did not require major surgery for RT-related complications decreased from 81% at 12 months to 66% at 60 months.

IN PRACTICE:

“This large-scale registry study of over 300 patients highlights the real-world burden of late genitourinary toxicity after prostate radiotherapy,” the authors wrote. Overall, “43% of the patients admitted for RT-related genitourinary complications presented with grade 3-5 toxicity.”

“This registry describes patients who had already presented with significant complications requiring urgent evaluation. It does not estimate how often severe side effects occur among all patients treated with prostate radiotherapy," Amar Kishan, MD, chair of the American Society for Radiation Oncology Genitourinary Resource Panel, told Medscape Medical News. "Large randomized trials with long-term follow-up reassuringly show rates of grade 3 or higher genitourinary side effects in the low single digits.”

SOURCE:

The study, led by Riccardo Bertolo, Azienda Ospedaliera Universitaria Integrata Verona in Verona, Italy, was published online in European Urology Oncology.

LIMITATIONS:

Because the registry enrolls only men presenting with complications, population-level incidence and causal effects cannot be inferred. Participating centers only captured cases of RT-related urologic complications that presented for care, potentially underestimating the true burden of toxicity. Additionally, there were differences in baseline age and comorbidity profiles between RT treatment settings.

DISCLOSURES:

The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.