Top Line: What are the long-term urinary continence outcomes following salvage, post-prostatectomy radiation?
The Study: Urinary incontinence is a frustrating problem to deal with in many prostatectomy patients who receive salvage radiation. SAKK 09/10 was a randomized trial that found dose escalation from 64 Gy in 32 fractions to 70 Gy in 35 fractions did not significantly reduce biochemical progression in prostate cancer patients receiving salvage RT. This study describes patterns of incontinence after salvage RT among patients enrolled in SAKK 09/10. At baseline, 32.2% had grade 1+ incontinence with 8.7% of those having grade 2+ incontinence. Dose escalation did not significantly impact the rates of post-treatment incontinence nor changes in continence over time. Among those who were continence at baseline, nearly half (47.2%) developed some degree of incontinence after treatment. However, only 16.2% of incontinent patients had worsening incontinence after RT whereas 54% had improvement and 29.7% remained stable. Factors significantly associated with late incontinence were nerve sparing technique, resection status, and age.
TBL: Roughly a third of post-prostatectomy, salvage RT patients have incontinence at baseline and roughly another third develop incontinence after treatment. Dose escalation was not associated with worse post-treatment incontinence. | Schroder, Radiother Oncol 2025
The Study: Urinary incontinence is a frustrating problem to deal with in many prostatectomy patients who receive salvage radiation. SAKK 09/10 was a randomized trial that found dose escalation from 64 Gy in 32 fractions to 70 Gy in 35 fractions did not significantly reduce biochemical progression in prostate cancer patients receiving salvage RT. This study describes patterns of incontinence after salvage RT among patients enrolled in SAKK 09/10. At baseline, 32.2% had grade 1+ incontinence with 8.7% of those having grade 2+ incontinence. Dose escalation did not significantly impact the rates of post-treatment incontinence nor changes in continence over time. Among those who were continence at baseline, nearly half (47.2%) developed some degree of incontinence after treatment. However, only 16.2% of incontinent patients had worsening incontinence after RT whereas 54% had improvement and 29.7% remained stable. Factors significantly associated with late incontinence were nerve sparing technique, resection status, and age.
TBL: Roughly a third of post-prostatectomy, salvage RT patients have incontinence at baseline and roughly another third develop incontinence after treatment. Dose escalation was not associated with worse post-treatment incontinence. | Schroder, Radiother Oncol 2025