title: Treatment-related toxicity and symptom-related bother following postoperative radiotherapy for prostate cancer.
abstract: BACKGROUND
  Patients have reported late effects and symptom-related bother following postoperative radiotherapy for prostate cancer.
  
  
  METHODS
  Patients treated with postoperative radiotherapy were surveyed at a median 56 months after radiotherapy using the Prostate Cancer Radiation Therapy instrument. A retrospective review was undertaken to obtain Radiation Therapy Oncology Group-Late Effects Normal Tissue (RTOG-LENT) toxicity scores at baseline and during follow-up.
  
  
  RESULTS
  Survey response was 64.5%. Median prostate bed radiation dose was 66 Gy given at a median 14 months after surgery. Adjuvant hormone therapy was given for 2 to 3 years to 40 patients; 22 received salvage therapy. PCRT impairment subscales were reported as mild for gastrointestinal dysfunction, moderate for genitourinary dysfunction and marked for sexual dysfunction. The use of one or more incontinence pads daily was reported by 25.6% and was similar to 23% use reported at baseline. Frequent or worse urinary frequency or hematuria was reported by 4.8%, and by 8.4% of respondents for bowel dysfunction. Moderate to severe disruption from bowel and bladder dysfunction was reported by up to 5.4% and 2.4% of respondents, respectively. Erectile function was described as poor to none in 88.3% of respondents, and dissatisfaction with sexual functioning was reported by 42.7%. Counselling or treatment was offered to 59% of those followed.
  
  
  CONCLUSIONS
  Combined surgery and postoperative radiotherapy are associated with low and moderate rates of bowel and bladder dysfunction respectively, with low reported bother. High levels of sexual dysfunction and bother are seen following combined therapy. More effective pre- and post-treatment counselling are required, along with research into more effective prevention and treatment strategies.
authors.affiliation: Department of Radiation Oncology, The Princess Margaret Hospital and University of Toronto, Toronto, ON;
authors.forename: Michael
authors.initials: M
authors.lastname: Sia
authors.forename: George
authors.initials: G
authors.lastname: Rodrigues
authors.forename: Cynthia
authors.initials: C
authors.lastname: Menard
authors.forename: Andrew
authors.initials: A
authors.lastname: Bayley
authors.forename: Robert
authors.initials: R
authors.lastname: Bristow
authors.forename: Peter
authors.initials: P
authors.lastname: Chung
authors.forename: Mary
authors.initials: M
authors.lastname: Gospodarowicz
authors.forename: Michael
authors.initials: M
authors.lastname: Milosevic
authors.forename: Padraig
authors.initials: P
authors.lastname: Warde
authors.forename: Charles
authors.initials: C
authors.lastname: Catton