Genitourinary Toxicity, Function, and Quality of Life in Patients Undergoing Prostate Radiation Therapy—A Scoping Review

Abstract

The effects of prostate radiotherapy (external beam radiation therapy (EBRT) and brachytherapy (BRT)) on urinary adverse events (UAEs), lower urinary tract function, and quality of life were examined in this scoping review. PubMed, Cochrane, and Embase (OVID) were used to identify relevant articles. We discuss the results of 23 studies. Included studies showed that UAEs are common after prostate radiation therapy. Across modalities, approximately one third experience acute events (Grade ≥ 2 median 36% for both EBRT and BRT), while one quarter experience late events (Grade ≥ 2 median 20% for EBRT and 26% for BRT). These estimates vary by UAE grading definitions and study designs. In the long term, patients with mild lower urinary tract symptoms (LUTS) report minimal improvement or worsening of urinary function after radiotherapy. Patients with moderate to severe baseline LUTS experience improvement in general but continue to experience bothersome LUTS. The limited urodynamic data show a similar pattern in which peak flow rate declines and post-void residual increases in the short term but return to baseline after long-term follow-up. These findings underscore the need for additional research to improve patient management and selection, and thereby improve genitourinary toxicity, function, and quality of life with contemporary radiotherapy techniques.