title: Patient-reported urinary incontinence following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer.
abstract: OBJECTIVE
  Urinary incontinence (UI) following prostate radiotherapy is a rare toxicity that adversely affects a patient's quality of life. This study sought to evaluate the incidence of UI following stereotactic body radiation therapy (SBRT) for prostate cancer.
  
  
  METHODS
  Between February, 2008 and October, 2010, 204 men with clinically localized prostate cancer were treated definitively with SBRT at Georgetown University Hospital. Patients were treated to 35-36.25 Gray (Gy) in 5 fractions delivered with the CyberKnife (Accuray). UI was assessed via the Expanded Prostate Index Composite (EPIC)-26.
  
  
  RESULTS
  Baseline UI was common with 4.4%, 1.0% and 3.4% of patients reporting leaking > 1 time per day, frequent dribbling and pad usage, respectively. Three year post treatment, 5.7%, 6.4% and 10.8% of patients reported UI based on leaking > 1 time per day, frequent dribbling and pad usage, respectively. Average EPIC UI summary scores showed an acute transient decline at one month post-SBRT then a second a gradual decline over the next three years. The proportion of men feeling that their UI was a moderate to big problem increased from 1% at baseline to 6.4% at three years post-SBRT.
  
  
  CONCLUSIONS
  Prostate SBRT was well tolerated with UI rates comparable to conventionally fractionated radiotherapy and brachytherapy. More than 90% of men who were pad-free prior to treatment remained pad-free three years following treatment. Less than 10% of men felt post-treatment UI was a moderate to big problem at any time point following treatment. Longer term follow-up is needed to confirm late effects.
authors: Leonard N
authors: LN
authors: Chen
authors: Simeng
authors: S
authors: Suy
authors: Hongkun
authors: H
authors: Wang
authors: Aditi
authors: A
authors: Bhagat
authors: Jennifer A
authors: JA
authors: Woo
authors: Rudy A
authors: RA
authors: Moures
authors: Joy S
authors: JS
authors: Kim
authors: Thomas M
authors: TM
authors: Yung
authors: Siyuan
authors: S
authors: Lei
authors: Brian T
authors: BT
authors: Collins
authors: Keith
authors: K
authors: Kowalczyk
authors: Anatoly
authors: A
authors: Dritschilo
authors: John H
authors: JH
authors: Lynch
authors: Department of Radiation Medicine, Georgetown University Hospital, 3800 Reservoir Road, N W, Washington, DC 20007, USA. SPC9@gunet.georgetown.edu.
authors: Sean P
authors: SP
authors: Collins
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D063868:Patient Outcome Assessment; D011379:Prognosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies; D057566:Self Report; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology*