title: Association of prostate size with urinary morbidity following mixed conformal neutron and photon irradiation.
abstract: OBJECTIVE
  This study was designed to characterize the relationship between the observed rate of postradiation genitourinary (GU) complications and the prostate gland size.
  
  
  METHODS
  Two hundred seventy-three patients received conformal neutron and photon irradiation to the prostate seminal vesicles. Data on post-treatment urinary morbidity were collected and examined in relationship to a number of clinical and technical factors.
  
  
  RESULTS
  With a median follow-up of 30 months (range 7-61), the 4-year rate of Grade 2 or higher GU complications was 21%. On univariate analysis, the risk of complications was significantly associated with prostate size and neutron beam arrangement. On multivariate analysis, only the prostate size was significantly associated with the risk of GU morbidity. Patients with a preradiation prostate volume more than 74 cc had a two and a half fold increase in the risk of complications compared to patients with smaller glands.
  
  
  CONCLUSIONS
  Patients with an enlarged prostate have a significantly higher risk of chronic GU complications. Although these data were obtained for patients receiving combined neutron and photon irradiation, it is likely that these data would also be applicable for those patients receiving photon irradiation as well. These observations may add an additional rationale for the study of preirradiation hormonal treatment.
authors.affiliation: Gershenson Radiation Oncology Center of the Barbara Ann Karmanos Cancer Institute and Wayne State University, Detroit, MI, USA. formanj@karmanos.org
authors.forename: J D
authors.initials: JD
authors.lastname: Forman
authors.forename: S
authors.initials: S
authors.lastname: Keole
authors.forename: S
authors.initials: S
authors.lastname: Bolton
authors.forename: S
authors.initials: S
authors.lastname: Tekyi-Mensah
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009502:Neutrons / Q000627:therapeutic use*; D017785:Photons / Q000627:therapeutic use*; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology* / Q000517:prevention & control; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D014566:Urogenital System / Q000528:radiation effects*