Diabetes Is an Independent Risk Factor for Radiation-Induced Hematuria After Robotic Stereotactic Body Radiotherapy...

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Prostate cancer management increasingly utilizes advanced radiation techniques.
• Stereotactic body radiation therapy (SBRT) offers precise radiation delivery.
• Understanding treatment-related toxicities like hematuria is crucial for patient care.

Purpose of the Study:

• To determine the incidence, timing, and clinical predictors of radiation-induced hematuria after robotic SBRT for prostate cancer.
• To assess the severity and management of this specific toxicity.
• To identify patient characteristics associated with increased risk.

Main Methods:

• Retrospective analysis of 397 patients treated with robotic SBRT for localized prostate cancer (2013-2019).
• All patients received 36.25 Gy in 5 fractions using a urethral sparing technique.
• Cox proportional hazards modeling was used to identify predictors of radiation-induced hematuria.

Main Results:

• 12.1% of patients developed radiation-induced hematuria at a median of 30 months post-treatment.
• Severe (Grade 3) hematuria was rare (1.3%).
• Diabetes was the only independent predictor of hematuria (HR 2.63), while age, anticoagulants, prostate volume, and Charlson Comorbidity Index were not significant.

Conclusions:

• Robotic SBRT for prostate cancer demonstrates a favorable genitourinary toxicity profile with predominantly low-grade, late-occurring hematuria.
• Diabetes is an independent risk factor for radiation-induced hematuria.
• Findings aid in patient counseling regarding potential SBRT side effects and highlight the need for further research on glycemic control's impact.