{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:42:25Z","timestamp":1785768145654,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose\/Objectives<\/jats:title><jats:p>Holmium laser enucleation of the prostate (HoLEP) is commonly performed in patients with significant bladder outlet obstruction. However, there are few reports on the toxicity of external beam irradiation (RT) for prostate cancer in patients after prior HoLEP. In this study, we evaluate the side effects and treatment outcomes of RT after HoLEP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials\/Methods<\/jats:title><jats:p>Eighteen patients who had HoLEP and subsequently received RT for prostate cancer were included. Data collected included patient and disease characteristics, urinary function, and radiation dose. Acute and late urinary (GU) and gastrointestinal (GI) side effects were evaluated. Disease control and survival rates were calculated using Kaplan\u2013Meier method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median follow\u2010up was 18\u2009months (range: 4\u201346\u2009months). Median prostate volume was 107\u2009ml before HoLEP and 24\u2009ml after HoLEP. Median International Prostate Symptom Score (IPSS) was 17 (range: 5\u201332) before HoLEP. Median decline in IPSS score after HoLEP was 7 (range: \u22122\u201321). On uroflow study, peak flow rate, and post\u2010void residual were significantly improved after HoLEP. After radiation, peak flow rate and average flow rate showed a decline but remained significantly improved compared to pre\u2010HoLEP measurements. Maximum acute Common Terminology Criteria for Adverse Events (CTCAE) adverse events were 12 grade 1 and 3 grade 2 for GU, and 3 grade 1 for GI, respectively. Maximum late adverse events were 13 grade 1 and 2 grade 2 for GU, and all grade 0 for GI, respectively. At last follow\u2010up, there were 8 grade 1 and 1 grade 2 late GU, and 3 grade 1 late GI adverse events, respectively. There was no significant increase in urinary incontinence after RT compared to before RT. The 18\u2010month biochemical control, local control, distant control rates were 78%, 94%, and 80%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients who received RT as definitive treatment for prostate cancer after prior HoLEP had low risk of serious acute and late side effects. HoLEP can be safely performed and should be considered in patients with significant bladder outlet obstruction and large prostate volume before RT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1672","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T09:34:11Z","timestamp":1657013651000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Toxicity and outcomes after external beam irradiation for prostate cancer in patients with prior holmium laser enucleation of the prostate: Early experience"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5384-1637","authenticated-orcid":false,"given":"Brady S.","family":"Laughlin","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gopi L.","family":"Narang","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott M.","family":"Cheney","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell R.","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos E.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer R.","family":"Keole","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic  Phoenix Arizona 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the gold standard for the surgical management of BPH in the 21(st) century","volume":"3","author":"Michalak J","year":"2015","journal-title":"Am J Clin Exp 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