Transient and chronic neurological complications of fast neutron radiation for adenocarcinoma of the prostate.
The records of 132 patients participating in clinical trials using fast neutron (n = 94), mixed neutron and photon (n = 16), or conventional photon (n = 22) irradiation for primary management of prostatic cancer were retrospectively reviewed to assess treatment-related neurological complications. With a median follow-up of 14 months (range 1 to 101 months), 31/132 patients (26 neutron, 3 mixed beam, 2 photon) have experienced either sciatica beginning during or shortly after treatment, or diminished bladder or bowel continence that developed at a median time of 6.5 months following treatment.  Sciatica responded to oral steroids and was usually self-limited, whereas sphincter dysfunction appears to be permanent. Pre-treatment risk factors for complications included a history of hypertension, diabetes, cigarette smoking or peripheral vascular disease, with 81% of affected patients having one or more risk factors compared with 55% of unaffected patients (p = 0.01). Seven patients have moderate (5) or severe (2) residual problems, all in the cohorts receiving neutrons (6/7) or mixed beam therapy (1/7).
Russell
K J
KJ
Department of Radiation Oncology, University of Washington, Seattle.
Laramore
G E
GE
Krieger
J N
JN
Wiens
L W
LW
Griffeth
J T
JT
Koh
W J
WJ
Griffin
B R
BR
Austin-Seymour
M M
MM
Griffin
T W
TW
Davis
L W
LW
D000230:Adenocarcinoma / Q000532:radiotherapy*; D005214:Fast Neutrons / Q000009:adverse effects; D005242:Fecal Incontinence / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*; D012189:Retrospective Studies; D012585:Sciatica / Q000209:etiology*; D013997:Time Factors; D014549:Urinary Incontinence / Q000209:etiology*