Men undergoing prostate cancer radiotherapy who have early side effects in treatment may face a higher risk of developing more serious long -term urine and intestinal health problems, according to a new study led by UCLA researchers .
The study found that patients with moderate acute urine side effects during the first three months after radiation were almost twice as likely to develop delayed urine complications later compared to those without early symptoms. Similarly, patients with bowel side effects had almost doubled the risk of chronic bowel problems.
The findings published in the Oncology LancetThey emphasize the importance of developing strategies for better management of acute toxicity to improve the long -term effects and quality of life of patients.
Men with prostate cancer live longer than ever and our goal is to reduce the risk of delayed toxicity, such as difficulty in tail or rectum bleeding, which can affect a patient’s quality of life for years. This study highlights the innovations we develop, such as the use of smaller prostate radiation margins to minimize early side effects, which can lead to constant benefits, also reducing the risk of long -term complications for patients. “
Dr Amar Kishan, Executive Vice President of Radiological Oncology at David Geffen School of Medicine in UCLA and a senior author of the study
Prostate cancer is the most common cancer among men, with radiotherapy that often serves as a basic treatment for local prostate cancer, which often includes higher doses for better disease control. While this approach effectively controls cancer, it can also damage the nearby healthy tissues, causing acute and delayed side effects.
Acute toxicity refers to side effects that occur during treatment or within the first three months after completion and are usually temporary. The common side effects of urine include an increased urinary frequency, difficulty in urinating and discomfort during urination. Side effects of the intestine may include softer stools or diarrhea, as well as rectal discomfort during bowel movements.
Delayed toxicity, on the other hand, may appear months or even years later and can last for years. Delayed urine toxicities include decreased urethra and blood in the urine. The delayed intestinal toxicities include blood on the stool or ulcer on the wall of the rectum. These issues can often have a greater impact on a person’s quality of life than the acute side effects.
While both acute and delayed toxicity are caused by the effect of radiation on healthy tissues, the connection between the two has not been well studied, especially using large -scale data.
To better understand this relationship, the researchers analyzed data from more than 6,500 patients from six randomized phase tests 3 clinical trials that distributed detailed data at the individual level on short and long -term side effects that affect urine and intestinal systems.
Researchers found that patients with moderate or worse first side effects were more likely to have serious delayed effects, even years after treatment. Men with premature urine or bowel issues were also more likely to report significant drops of their ability to manage daily activities and overall quality of life.
For urine toxicity, the experience of acute toxicity increased the rate of delayed toxicity from 7.5% to 12.5% ​​and for bowel toxicity, the experience of acute toxicity increased the rate of delayed toxicity from 12.7% to 22, 5%.
The chances of having a significant decrease in urine quality of life were 1.4 times higher for men with moderate acute urine toxicity. The chances of clinically significantly reduced bowel life were 1.5 times higher for men with moderate acute bowel toxicity.
“These results show that acute toxicity after prostate radiotherapy is associated with delayed toxicities months and years later,” said Dr. John Nikitas, a resident of the Radiation Department in UCLA Health and the first author of the study. “This emphasizes the importance of measures that reduce the risk of acute toxicity, as they may also improve the long -term effects and quality of life of patients.”
Kishan, who is also a researcher at the UCLA Health Jonsson Comprehensive Cancer Center, underlined the possible impact of newer techniques to reduce both acute and delayed toxicity.
“Reduction of early side effects through advanced techniques such as MRI -guided radiation, which allows for more accurate tumor targeting and urethral methods, which use dividers between the prostate to protect the surrounding tissues and the rectum could possibly They help reduce the risk of lasting side effects, “Kishan said.
However, more studies are needed to determine whether specific strategies to reduce early side effects will improve the long -term effects and whether short -term side effects can help prevent long -term complications.
Other authors of UCLA are Dr. Michael Steinberg, Dr. Luca Valle, Dr. Joanne Weidhaas, Parsa Jamshidian, Donatello Telesca and Tahmineh Romero. A complete list of authors is included in the article.
The study was partially supported by grants by the National Institutes of Health and the Ministry of Defense.
Source:
Magazine report:
Nikitas, J., et al. (2025). The interaction between acute and delayed toxicity among patients receiving prostate radiotherapy: individual meta-analysis of patients with six randomized tests. The oncology Lancet. Doi.org/10.1016/S1470-2045(24)).
