703 860
Ost et al
[110]104 pts undergoing
aRT
IMRT within 7 mo from
surgery with a median
dose of 74 Gy
36 mo
8% reported Grade 3 acute GU
toxicity
4% developed late Grade 3 GU
toxicity
Urethral stricture observed in
6 pts
2 patients had worsening of
incontinence
NA
No patients experienced Grade
3 acute GI toxicity
No patients developed Grade
3 late GI toxicity
Noncomparative study
Alongi et al
[61]
172
81 vs 91 pts received
3DCRT vs IMRT
NA
No Grade 3 or higher GU toxicity NA
No Grade 3 or higher lower GI
toxicity
Acute upper GI toxicity: 22.2 vs
6.6% (
p
= 0.004)
Lack of comparison between
aRT and sRT
Treatment interruption due to
toxicity higher in the 3DCRT
group (11 vs 2 pts,
respectively;
p
= 0.006)
Goenka et al
[67]
285 pts treated with
sRT
109 vs 176 pts received
3DCRT vs IMRT
60 mo
IMRT was not associated with a
reduction in risk of Grade 2 or
higher GU toxicity and
incontinence
No differences in the rates
of erectile dysfunction
IMRT was independently
associated with a reduction in
Grade 2 or higher GI toxicity
compared with 3D-CRT (5-yr
1.9 vs 10.2%; p = 0.02)
All pts treated with sRT
Cremers et al
[68]
197 pts treated with
sRT
3D-CRT for detectable
PSA levels after surgery
or BCR
40 mo
37% pts experienced Grade 2 or
higher late GU toxicity
50% of pts reported some degree
of incontinence
NA
1.6% pts experienced Grade 2 or
higher late GI toxicity
No Grade 4 side effects were
reported
Cozzarini et al
[62]
556 vs 186 pts
treated with aRT vs
sRT
RT within 6 mo from
surgery irrespective of
PSA
99 mo
Similar risk of Grade 2 or 3 late
urinary toxicity (23.9 vs 23.7%
and 12 vs 10%)
NA
NA
The control group does not
include patients treated with
observation alone
Suardi et al
[11]
208 pts treated with
no aRT vs 153 pts
receiving aRT
3DCRT within 6 mo
from surgery in the
presence of
undetectable
postoperative PSA
30 mo
The 1- and 3-yr urinary
continence recovery was 51%
and 59% for patients submitted
to aRT vs 81% and 87% for
patients not receiving aRT
(
p
<
0.001)
NA
NA
UC defined as the use of no
pads over the 24-h period
Lack of use of validated
questionnaires
Cozzarini et al
[66]
929 vs 247 pts
treated with
conventionally
fractionated vs
hypofractionated RT
Patients treated with
both aRT and sRT
included
98 mo
5-yr late GU toxicity 6.9 vs 18.1%
Dose fraction independently
associated with the risk of GU
toxicity
NA
NA
Heterogeneity in the type of RT
administered
Sowerbi et al
[63]
162 vs 490 pts
treated with aRT vs
sRT
RT delivered within
6 mo from surgery
Minimum
follow-up:
36 mo
The rate of incontinence was
similar between aRT and sRT at
3-yr: 24.5 vs 23.3%
NA
NA
Urinary incontinence was
defined as the presence of any
reported leakage
Lack of use of validated
questionnaires
Hegarty et al
[64]
4509 vs 894 vs
734 pts treated with
RP only vs aRT vs
sRT
RT within 9 mo from
surgery
64 vs
62.9 vs
84.2 mo
Higher risk of incontinence for
aRT and sRT vs RP alone
Lower risk of erectile
dysfunction for aRT vs RP
alone and sRT
Higher risk of GI complications
for aRT and sRT vs RP alone
Population-based study
Urinary, sexual, and bowel
complications defined
according to administrative
codes
Lack of details on type of RT
administered
van Praet et al
[70]
48 vs 239 pts treated
with WPRT vs
prostatic bed only
IMRT; 75 Gy to the
prostatic bed 54 Gy to
the pelvic area
12 vs
45 mo
After WPRT, 35% developed
Grade 2 and 4% Grade 3 acute GU
toxicity
GU toxicity was similar between
WPRT and prostatic bed only
NA
Incidence of acute and late GI
toxicity was higher following
WPRT compared to PBRT
(
p
= 0.04)
All pts received ADT
All pts receiving WPRT had N1
disease at final pathology
E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 6 8 9 – 7 0 9
703