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. Author manuscript; available in PMC: 2022 May 1.
Published in final edited form as: Int J Radiat Oncol Biol Phys. 2020 Dec 22:S0360-3016(20)34356-X. doi: 10.1016/j.ijrobp.2020.09.054

Table 1.

Selected studies analyzing factors associated with late urinary side effects

Study n Treatment details Med. f/u (yrs) Urinary endpoint Dosimetric factors associated* with worse urinary outcomes Non-dosimetric factors associated* with worse urinary outcomes
King 201220 (Stanford) 67 36.25 Gy (5 fx), QD/QOD 2.7 RTOG
G2: 5.0%
G3: 3.5%

  • QD (vs. QOD) treatment schedule (for RTOG ≤ G2 toxicity)

  • Urologic instrumentation
Bolzicco 201321 (Vicenza) 100 35 Gy (5 fx), QD 3.0 RTOG
G2: 3.0%
G3: 1.0%

  • Prior procedure for BPH
Elias 201422 (Sunnybrook) 84 35 Gy (5 fx), QW 4.2 EPIC QOL
MID: 17.9%

  • Bladder D5cc > 34 Gy

  • Bladder volume
Katz 201423 (Flushing) 515 35–36.25 Gy (5 fx), QD 6.0 RTOG
G2:9.1%
G3: 1.7%

  • - Prescription dose 36.25 Gy (vs. 35 Gy)

  • Prostate volume > 60 cc
Bernetich 201424 (Drexel) 142 79%: 35–36.25 Gy (5 fx), QOD 21%: 37.5 Gy (5 fx), QOD 3.0 CTCAE v3
G2: 14%
G3: 2%

  • Prescription dose 37.5 Gy (vs. 35–36.25 Gy)
Gurka 201525 (Georgetown) 208 35–36.25 Gy (5 fx), QOD
 4.0 CTCAE v4 ≥G2 bleed: 2.4%

  • Prostate volume

  • Prior procedure for BPH

  • Alpha antagonist use
Gomez 201526 (UCLA) 75 40 Gy (5 fx), QOD 1.0 EPIC QOL (Avg of Obs/irrit and Incont)

  • Bladder V40Gy > 5.5 cc

  • Larger prostate volume
Seymour 201527 (UCSF) 56 38 Gy (4 fx), QD/QOD 3.0 CTCAE v4
G2: 19.6%
G3: 3.6%

  • Urethra Dmax > 47 Gy

  • Urethra V44Gy

  • Bladder V19Gy

  • More heterogeneous plan

  • Prostate volume ≥ 50 cc
Qi 201628 (UCLA) 86 40 Gy (5 fx), QOD 1.0 EPIC QOL
Obs/irrit MID: 46%
Incont MID: 28%

  • Bladder mean (Obs/irrit, Incont)

  • Bladder V34–40Gy (Obs/irrit)

  • Bladder D2–10cc (Obs/irrit)

  • Larger prostate volume (Incont)
Kole 201629 (Georgetown) 216 35–36.25 Gy (5 fx), QOD 4.0 IPSS
Late urinary flare:
13%

  • Bladder D12.7% > 33.5 Gy

  • Age < 65
Helou 201730 (Sunnybrook) 259 32%: 35 Gy (5 fx), QW
39%: 40 Gy (5 fx), QW
29%: 40 Gy (5 fx), QOD		 3.2 RTOG
G2: 32.6%
G3: 1.9%

  • - Prescription dose 40 Gy (vs. 35 Gy)

  • Higher age

  • Shorter treatment duration
Zhang 201731 (UCSF) 78 38 Gy (4 fx), QD/QOD 3.0 CTCAE v4
G2: 19.2%
G3: 2.6%

  • Urethra V42Gy

  • Shorter treatment duration

  • More heterogeneous plan
Jackson 201832 (Multicenter) 66 37 Gy (5 fx), QOD 3.1 EPIC QOL Obs/irrit MID:
25%
Incont MID: 24%

  • Bladder Dmax (Obs/irrit)

  • Bladder V3.7–37Gy (Incont)

Abbreviations: QW; every week, QOD; every other day, QD; every day, MID; minimally important difference, Obs/irrit, obstruction/irritation domain; Incont, incontinence domain.

*

Included if reported as trend or significant on univariate or multivariate analysis