title: Predictive factors for late genitourinary and gastrointestinal toxicity in patients with prostate cancer treated with adjuvant or salvage radiotherapy.
abstract: OBJECTIVE
  To determine the rate and magnitude of late genitourinary (GU) and gastrointestinal (GI) toxicities after salvage or adjuvant radiotherapy (RT) for prostate cancer, and to determine predictive factors for these toxicities.
  
  
  METHODS
  A large multi-institutional database that included 959 men who received postoperative RT after radical prostatectomy (RP) was analyzed: 19% received adjuvant RT, 81% received salvage RT, 78% were treated to the prostate bed only, and 22% received radiation to the pelvis.
  
  
  RESULTS
  The median follow-up time was 55 months. At 5 years, 10% of patients had Grade 2 late GU toxicity and 1% had Grade 3 late GU toxicity, while 4% of patients had Grade 2 late GI toxicity and 0.4% had Grade 3 late GI toxicity. Multivariate analysis demonstrated that adjuvant RT (p = 0.03), androgen deprivation (p < 0.0001), and prostate bed-only RT (p = 0.007) predicted for Grade 2 or higher late GU toxicity. For GI toxicity, although adjuvant RT was significant in the univariate analysis, no significant factors were found in the multivariate analysis.
  
  
  CONCLUSIONS
  Overall, the number of high-grade toxicities for postoperative RT was low. Therefore, adjuvant and salvage RT can safely be used in the appropriate settings.
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109-0010, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Feng
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Hanlon
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Pisansky
authors.forename: Deborah
authors.initials: D
authors.lastname: Kuban
authors.forename: Charles N
authors.initials: CN
authors.lastname: Catton
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Michalski
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zelefsky
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Kupelian
authors.forename: Alan
authors.initials: A
authors.lastname: Pollack
authors.forename: Larry L
authors.initials: LL
authors.lastname: Kestin
authors.forename: Richard K
authors.initials: RK
authors.lastname: Valicenti
authors.forename: Theodore L
authors.initials: TL
authors.lastname: DeWeese
authors.forename: Howard M
authors.initials: HM
authors.lastname: Sandler
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000209:etiology*; D008875:Middle Aged; D011349:Proctitis / Q000209:etiology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D016879:Salvage Therapy / Q000009:adverse effects* / Q000379:methods