Effect of Short-Term Corticosteroid Usage on Acute Urinary Toxicity Following Cs-131 Prostate Brachytherapy.
Brachytherapy（2022）
UPMC Hillman Canc Ctr
Abstract
PURPOSE: To evaluate short-term patient reported urinary quality of life scores in patients with prostate cancer treated at our institution with and without perioperative prednisone following Cesium-131 (Cs-131) prostate LDR brachytherapy. METHODS AND MATERIALS: We started routinely using a perioperative 7-day course of prednisone at a dose of 5 mg per day, beginning 1 day prior to Cs-131 prostate LDR brachyther-apy from 2013 with goal of improving acute urinary symptomatology. One hundred consecutive patients treated with prednisone were selected, with comparison to 100 consecutive patients who were not treated with prednisone. We analyzed for differences in mean change with standard deviation (SD) in EPIC and AUA scores at 0.5-1 month and 3 months with or without pred-nisone by Mann-Whitney U Test. Binary logistic regression was performed to assess for impact of prednisone on postoperative urinary catheter use. RESULTS: Pretreatment EPIC and AUA scores were available in 197 patients. Less reduction in EPIC US score was noted at 0.5-1.0 month in the group who received prednisone with mean change of-22.9 (SD 15.4) when compared to the group who did not receive prednisone with mean change of-31.7 (SD 19.3), p < 0.01, with significance lost at 3 months. There was no significant difference in acute urinary retention requiring postoperative urinary catheter placement with perioperative prednisone (OR 1.13, p = 0.71). CONCLUSIONS: A short course of perioperative low-dose prednisone was associated with less severe worsening in urinary symptoms by the EPIC questionnaire at the 0.5-1.0-month timepoint suggesting some improvement in acute urinary quality of life, although differences did not re-main statistically significant at 3 months.(C) 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
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Key words
Cesium-131,Low-dose rate prostate brachytherapy,Prednisone,Corticosteroids,Acute quality of life
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