Rüedi Gianni, Pratsinis Manolis, Schmid Hans-Peter, Güsewell Sabine, Putora Paul M, Plasswilm Ludwig, Schwab Christoph, Burkhardt Orlando, Thoeni Armin, Hochreiter Werner, Prikler Ladislav, Suter Stefan, Stucki Patrick, Müntener Michael, Blick Nadja, Schiefer Hans, Müllhaupt Gautier, Engeler Daniel S
Department of Urology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland.
Clinical Trial Unit, St. Gallen Cantonal Hospital, St. Gallen, Switzerland.
Eur Urol Open Sci. 2024 Dec 2;71:31-37. doi: 10.1016/j.euros.2024.11.004. eCollection 2025 Jan.
Our aim was to develop a tool using readily available clinical parameters to predict the probability of poor urinary function following low-dose-rate brachytherapy (LDR-BT) for localized prostate cancer.
Data from the multicentre, prospective Swiss LDR-BT cohort were analyzed for men treated with LDR-BT. Inclusion criteria were minimum follow-up of 3 yr or postoperative treatment with transurethral resection of the prostate (TURP). A total of 914 men were analyzed, with complete data available for 607 men. Pre-interventional variables assessed were International Prostate Symptom Score (IPSS), prostate volume (PV), maximum urinary flow rate, prostate-specific antigen, postvoid residual urine volume, and age. The primary outcome was poor urinary function after LDR-BT, defined as an IPSS-Quality of Life score >3 ("mostly dissatisfied" or worse) at 3 yr or the occurrence of TURP during follow-up. Associations were evaluated using univariable and multivariable logistic regression. Receiver operating characteristic curve analysis was also performed.
Poor urinary function outcomes were observed in 46 patients (5.0%). Significant predictors included pre-interventional IPSS (adjusted odds ratio [aOR] per point 1.18; < 0.001) and PV (aOR per ml, 1.04; = 0.004). Limitations of the study include potential selection bias and the absence of external validation.
Pre-interventional IPSS and PV were significant predictors of poor urinary function after LDR-BT for prostate cancer. A risk calculator based on these parameters was developed to assist individualized treatment planning. Further studies are needed to validate these findings before they can be applied in routine clinical practice.
We created a tool to predict the likelihood of urinary problems after a type of radiotherapy called brachytherapy for prostate cancer. The size of the prostate and urinary symptoms before treatment were associated with poor urinary function after treatment. This tool could help doctors and patients in making informed decisions about treatment for prostate cancer.
我们的目标是开发一种工具，利用现有的临床参数来预测局部前列腺癌患者在接受低剂量率近距离放射治疗（LDR-BT）后出现排尿功能不佳的概率。
对多中心前瞻性瑞士LDR-BT队列中接受LDR-BT治疗的男性患者的数据进行分析。纳入标准为至少随访3年或接受经尿道前列腺切除术（TURP）的术后治疗。共分析了914名男性患者，其中607名患者有完整数据。评估的干预前变量包括国际前列腺症状评分（IPSS）、前列腺体积（PV）、最大尿流率、前列腺特异性抗原、残余尿量和年龄。主要结局是LDR-BT后排尿功能不佳，定义为3年时IPSS-生活质量评分>3（“大多不满意”或更差）或随访期间发生TURP。使用单变量和多变量逻辑回归评估相关性。还进行了受试者工作特征曲线分析。
46例患者（5.0%）出现排尿功能不佳的结局。显著预测因素包括干预前IPSS（每增加1分调整后的优势比[aOR]为1.18；<0.001）和PV（每毫升aOR为1.04；=0.004）。本研究的局限性包括潜在的选择偏倚和缺乏外部验证。
干预前IPSS和PV是前列腺癌患者接受LDR-BT后排尿功能不佳的显著预测因素。基于这些参数开发了一个风险计算器，以协助进行个体化治疗规划。在这些发现应用于常规临床实践之前，需要进一步研究来验证。
我们创建了一种工具来预测一种名为近距离放射治疗的前列腺癌放疗后出现泌尿问题的可能性。治疗前前列腺的大小和泌尿症状与治疗后排尿功能不佳有关。该工具可以帮助医生和患者对前列腺癌的治疗做出明智的决策。
