title: Transient and chronic neurological complications of fast neutron radiation for adenocarcinoma of the prostate.
abstract: 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).
authors.affiliation: Department of Radiation Oncology, University of Washington, Seattle.
authors.forename: K J
authors.initials: KJ
authors.lastname: Russell
authors.forename: G E
authors.initials: GE
authors.lastname: Laramore
authors.forename: J N
authors.initials: JN
authors.lastname: Krieger
authors.forename: L W
authors.initials: LW
authors.lastname: Wiens
authors.forename: J T
authors.initials: JT
authors.lastname: Griffeth
authors.forename: W J
authors.initials: WJ
authors.lastname: Koh
authors.forename: B R
authors.initials: BR
authors.lastname: Griffin
authors.forename: M M
authors.initials: MM
authors.lastname: Austin-Seymour
authors.forename: T W
authors.initials: TW
authors.lastname: Griffin
authors.forename: L W
authors.initials: LW
authors.lastname: Davis
mesh_terms: 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*