Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer.

Area of Science:

• Urology
• Radiation Oncology
• Medical Informatics

Background:

• Localized prostate cancer treatment often involves low-dose-rate brachytherapy (LDR-BT).
• Predicting post-treatment urinary function is crucial for patient quality of life.
• Existing prediction tools may not fully utilize readily available clinical parameters.

Purpose of the Study:

• To develop a predictive tool for poor urinary function following LDR-BT for prostate cancer.
• To identify key pre-interventional clinical parameters associated with urinary dysfunction.
• To aid in individualized treatment planning for prostate cancer patients undergoing LDR-BT.

Main Methods:

• Analysis of a prospective Swiss LDR-BT cohort (n=607) with a minimum 3-year follow-up.
• Assessment of pre-interventional variables including International Prostate Symptom Score (IPSS) and prostate volume (PV).
• Logistic regression and receiver operating characteristic (ROC) curve analysis to identify predictors of poor urinary function (defined as IPSS-Quality of Life >3 or TURP).

Main Results:

• Poor urinary function was observed in 5.0% of patients.
• Pre-interventional IPSS (aOR 1.18) and PV (aOR 1.04) were significant predictors of poor urinary function.
• Study limitations include potential selection bias and lack of external validation.

Conclusions:

• Pre-treatment IPSS and PV are significant predictors of post-LDR-BT urinary function.
• A risk calculator based on these parameters can assist in personalized treatment planning.
• Further validation is needed before routine clinical application.