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BMC Urology
Published in: BMC Urology 1/2017

Open Access 01-12-2017 | Research article

Assessment of lower urinary symptom flare with overactive bladder symptom score and International Prostate Symptom Score in patients treated with iodine-125 implant brachytherapy: long-term follow-up experience at a single institute

Authors: Makito Miyake, Nobumichi Tanaka, Isao Asakawa, Shunta Hori, Yosuke Morizawa, Yoshihiro Tatsumi, Yasushi Nakai, Takeshi Inoue, Satoshi Anai, Kazumasa Torimoto, Katsuya Aoki, Masatoshi Hasegawa, Tomomi Fujii, Noboru Konishi, Kiyohide Fujimoto

Published in: BMC Urology | Issue 1/2017

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Abstract

Background

The aim of this study was to evaluate the combined use of the overactive bladder symptom score (OABSS) and International Prostate Symptom Score (IPSS) as an assessment tool for urinary symptom flare after iodine-125 (125I) implant brachytherapy. The association between urinary symptom flare and prostate-specific antigen (PSA) bounce was investigated.

Methods

Changes in the IPSS and OABSS were prospectively recorded in 355 patients who underwent seed implantation. The percentage distribution of patients according to the difference between the flare peak and post-implant nadir was plotted to define significant increases in the scores. The clinicopathologic characteristics, treatment parameters, and post-implant dosimetric parameters were compared between the non-flare and flare groups. PSA bounce was defined as an elevation of ≥0.1 ng/mL or ≥0.4 ng/mL compared to the previous lowest value, followed by a decrease to a level at or below the pre-bounce value.

Results

A clinically significant increase required an IPSS increase of at least 12 points and an OABSS increase of at least 6 points based on a time-course analysis of total scores and the QOL index. Assessment only by IPSS failed to detect 40 patients (11%) who had urinary symptom flare according to the OABSS. Univariate and multivariate analyses revealed that patients treated with higher biologically effective doses and those without diabetes mellitus had higher risks of urinary flare. There was no statistical correlation between the incidence and time of urinary symptom flare onset and that of a PSA bounce.

Conclusions

To our knowledge, this is the first report to prove the clinical potential of the OABSS as an assessment tool for urinary symptom flare after seed implantation. Our findings showed that persistent lower urinary tract symptoms after seed implantation were attributed to storage rather than to voiding issues. We believe that assessment with the OABSS combined with the IPSS would aid in decision-making in terms of timing, selection of a treatment intervention, and assessment of the outcome.
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Metadata
Title
Assessment of lower urinary symptom flare with overactive bladder symptom score and International Prostate Symptom Score in patients treated with iodine-125 implant brachytherapy: long-term follow-up experience at a single institute
Authors
Makito Miyake
Nobumichi Tanaka
Isao Asakawa
Shunta Hori
Yosuke Morizawa
Yoshihiro Tatsumi
Yasushi Nakai
Takeshi Inoue
Satoshi Anai
Kazumasa Torimoto
Katsuya Aoki
Masatoshi Hasegawa
Tomomi Fujii
Noboru Konishi
Kiyohide Fujimoto
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2017
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-017-0251-1

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