Aim: To evaluate the relationship between clinical/dosimetric factors and late fecal incontinence (linc) after high-dose radiotherapy (RT) in prostate cancer patients (patients) accrued in AIROPROS 0102 trial (RT doses: 70-80 Gy, 1.8-2 Gy/fraction). Toxicity was defined using a longitudinal parameter (mlinc) which took into account both the severity and duration of symptoms. Patients and Methods: Self-reported questionnaires of 586 patients enrolled in the AIROPROS 0102 trial with a minimum follow-up of 36 months were analyzed with respect to linc. Only patients with a G0 basal linc were included (550/586). mlinc was defined as the mean score for fecal incontinence calculated over the whole follow-up period. G1 linc was scored if unintentional stool discharge was sometimes experienced; G2 linc was scored if unintentional stool discharge was experienced often or if patients used sanitary pads sporadically; G3 linc was scored if patients reported daily unintentional stool discharge or use of sanitary pad more than twice/week. The correlation between pretreatment morbidities, hormonal therapy, drug prescription, presence of diabetes or hypertension, abdominal surgery prior to RT, presence of acute lower gastrointestinal toxicity, irradiation of pelvic nodes and seminal vesicles, mean rectal dose, constraints of dose–volume histograms (from V20Gy to V75Gy) and mlinc was investigated by uni- and multivariate logistic analyses. Results: mlinc was a continuous variable (range, 0-2.7 in this population). A total of 197/550 patients had mlinc >0, thus, 35.8% of patients experienced some linc symptoms during the follow-up period; 22/550 patients had mlinc ≥1; thus, 4% of patients had either a persistent G1 linc or a G2-G3 linc which never completely recovered. Figure 1 shows mlinc as a function of V40Gy. A clear relationship can be seen between the dose at V40Gy and mlinc. In multivariate analysis (overall p=0.0034), V40Gy (continuous variable, p=0.02, OR=1.035), use of antihypertensive protective factors (p=0.02, OR=0.28), presence of colon morbidity before RT (p=0.04, OR=4.3) and abdominal surgery before RT (p=0.17, OR=2.5) were correlated to mlinc ≥1. A nomogram was developed for the prediction of mlinc ≥1 (Figure 2). Conclusion: The use of a longitudinal definition of linc was useful for taking both the duration and the severity of symptoms into account. The use of mlinc provided additional information which was ANTICANCER RESEARCH 31: 1807-1956 (2011) Figure 1 Figure 2 1932 not seen by analyzing linc, as peak toxicity (corresponding to the maximum grade of linc) and a stronger relationship between dosimetric (V40Gy) and clinical risk factors (use of antihypertensives, presence of colon morbidity before RT and previous abdominal surgery) were revealed. 223 IMPACT <strong>OF</strong> TRANSRECTAL PROSTATE BIOPSY ON ERECTILE FUNCTION: A PROSPECTIVE STUDY USING <strong>THE</strong> INTERNATIONAL INDEX <strong>OF</strong> ERECTILE FUNCTION (IIEF) Fabrizio Lorusso, Luigi Cormio, Oscar Selvaggio, Antonia Perrone, Giuseppe Di Fino, Paolo Massenio, Giuliano Ciavotta, Nicola Ruocco, Giuseppe Liuzzi and Giuseppe Carrieri Department of Urology and Renal Transplantation, University of Foggia, Italy Background: Erectile dysfunction (ED) is a rare, although possible, complication after prostate biopsy. Nevertheless, only few studies have prospectively analyzed this issue through validated questionnaires. The aim of this study was to evaluate the impact of transrectal prostate biopsy (TPB) on erectile function through the use of the International Index of Erectile Function-5 (IIEF-5) questionnaire. Patients and Methods: Between June 2008 and June 2010, all patients scheduled for TPB in our Department completed the IIEF-5 questionnaire before the procedure. A total of 200 among them who were diagnosed with prostate cancer and scheduled for retropubic radical prostatectomy (RRP) were asked to complete the IIEF- 5 questionnaire again before RRP. Results: The mean patient age was 56 years, mean PSA was 6.3 ng/ml and mean prostate volume was 47 cm3. The mean IIEF-5 score was 21 before TPB and 20 before RRP, and this difference was not significant. However, while in patients ≥65 years of age, the mean IIEF-5 score was 19 before TPB and before RRP, in patients
Abstracts of the <strong>21st</strong> Annual Meeting of the Italian Society of Uro-Oncology (SIUrO), 22-24 June, 2011, Naples, Italy 39 and 54 patients (19.5 and 27%, respectively) underwent unilateral and bilateral nerve-sparing RRP, respectively. Of the 104 patients