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External beam radiotherapy combination is a risk factor for bladder cancer in patients with prostate cancer treated with brachytherapy

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Abstract

Purpose

To investigate the risk of bladder cancer (BCa) in patients treated with brachytherapy for prostate cancer (PCa).

Methods

We retrospectively analyzed 583 patients with PCa who underwent brachytherapy with or without external beam radiotherapy (EBRT). We analyzed the disease-free survival (DFS) of BCa in patients with PCa who underwent brachytherapy with or without EBRT. We performed multivariate Cox regression analyses of DFS using age, EBRT, and Brinkman index (BI) score (number of cigarettes smoked per day × number of years smoking) ≥ 200 as variables for BCa after brachytherapy.

Results

Fourteen patients (2.4%) developed BCa after brachytherapy with or without EBRT. The percentage of high-grade urothelial carcinoma (UC) was 63.6%. A total of 85.7% of patients had non-muscle invasive BCa, and 14.3% of patients had muscle invasive BCa. DFS was longer in brachytherapy monotherapy than in combination therapy (brachytherapy + EBRT). Multivariate Cox regression analysis showed that a BI score ≥ 200 (Hazard Ratio (HR 8.61; 95% Confidence Interval (CI) 1.12–65.98) and EBRT combination (HR 3.29; 95% CI 1.03–10.52) were significantly associated with BCa development in patients with PCa treated with brachytherapy. Furthermore, patients with BI score ≥ 200 and EBRT combination had a significantly higher risk of BCa compared with patients with BI score < 200 (HR Log-rank test P = 0.010).

Conclusion

Most cases of BCa after brachytherapy with or without EBRT are high grade and invasive. We hypothesized that the EBRT combination might be a risk factor for BCa in patients with PCa who underwent brachytherapy.

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Data availability

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

None.

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Authors and Affiliations

  1. Department of Urology, Kindai University, Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan

    Takafumi Minami, Kazutoshi Fujita, Mamoru Hashimoto, Mitsuhisa Nishimoto, Shogo Adomi, Eri Banno, Masahiro Nozawa, Kazuhiro Nose, Kazuhiro Yoshimura & Hirotsugu Uemura

  2. Department of Radiation Oncology, Kindai University, Faculty of Medicine, Osakasayama, Osaka, Japan

    Masahiro Inada, Masaki Yokokawa & Kiyoshi Nakamatsu

Authors
  1. Takafumi Minami
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  2. Kazutoshi Fujita
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  3. Mamoru Hashimoto
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  4. Mitsuhisa Nishimoto
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  5. Shogo Adomi
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  6. Eri Banno
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  7. Masahiro Nozawa
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  8. Kazuhiro Nose
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  9. Kazuhiro Yoshimura
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  10. Masahiro Inada
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  11. Masaki Yokokawa
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  12. Kiyoshi Nakamatsu
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  13. Hirotsugu Uemura
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Contributions

TM: project development, data collection, data analysis, manuscript writing. KF: data analysis, manuscript writing. MH: data collection. MN: data collection. SA: data collection. EB: data analysis. MN: project development, data collection. KN: data collection. KY: project development, data collection. MI: data collection. MY: data collection. KN: project development, data collection. HU: project development, data collection.

Corresponding author

Correspondence to Takafumi Minami.

Ethics declarations

Conflict of interest

All authors declare no conflicts of interest.

Research involving human participants and/or animals

The study protocol was approved by the Institutional Ethics Review Board of Kindai University (approval no. R02-155).

Informed consent

Written informed consent was waived owing to the retrospective design.

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Minami, T., Fujita, K., Hashimoto, M. et al. External beam radiotherapy combination is a risk factor for bladder cancer in patients with prostate cancer treated with brachytherapy. World J Urol 41, 1317–1321 (2023). https://doi.org/10.1007/s00345-023-04380-5

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  • DOI: https://doi.org/10.1007/s00345-023-04380-5

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