{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:49:48Z","timestamp":1759333788809,"version":"build-2065373602"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Purpose\/objectives<\/jats:title><jats:p>SBRT is a standard of care treatment for localized prostate cancer. Whole gland dose escalation remains controversial. Concomitant intraprostatic boost (IPB) may offer an acceptable compromise for dose escalation. In this series, we report changes in International Prostate Symptom Scores (IPSS) over a 12-month period following SBRT with IPB in patients treated in a large academic institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials\/methods<\/jats:title><jats:p>Seventy-four patients treated from October 2018 to March 2022 with robotic stereotactic body radiotherapy completed IPSS questionnaires. IPSS were evaluated for patients at three timepoints: pre-treatment, post-treatment (defined as 3 months after SBRT completion), and at follow-up (defined as within 12 months after SBRT completion). The patients were stratified into two cohorts: patients who experienced minimally important difference (MID) in their post-treatment IPSS and those who did not. Urethral and bladder doses were retrospectively extracted from the treatment planning software and compared between the two cohorts using Wilcoxon rank sum test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 74 patients, 46 (62%) experienced MID in scores (cohort A), while 28 (38%) did not (cohort B). Patient characteristics in the two cohorts such as risk stratification and initial PSA were well-balanced. Median IPSS for cohort A were 5 (range: 0\u201321) pre-treatment, 12 (range: 3\u201328) post-treatment, and 8 (range: 1\u201332) at 12 months. For cohort B, the scores were 9.5 (range: 0\u201329), 7 (range: 1\u201319), and 8.5 (range: 0-32), respectively. In addition, there was a statistically significant difference in D0.03cc to the bladder in cohort A compared to cohort B (41.9 Gy vs 40.2 Gy; p &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IPB is well tolerated with acceptable change in urinary quality of life metrics as measured by IPSS. Max dose to the bladder remains the only significant difference in patients who experienced MID in their urinary quality of life.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1622191","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:11:33Z","timestamp":1759205493000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary quality of life in patients treated with prostate SBRT with intra-prostatic boost"],"prefix":"10.3389","volume":"15","author":[{"given":"Nisha","family":"Bhargava","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Hurwitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josephine","family":"Levey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lily","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A.","family":"Aronovitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liana","family":"Dawson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan W.","family":"Lischalk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irving D.","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nima","family":"Aghdam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2403365","article-title":"Phase 3 trial of stereotactic body radiotherapy in localized prostate cancer","volume":"391","author":"van As","year":"2024","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2017.1299221","article-title":"Predictors of acute urinary symptom flare following stereotactic body radiation therapy (SBRT) in the definitive treatment of localized prostate cancer","volume":"56","author":"Repka","year":"2017","journal-title":"Acta Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.03.065","article-title":"Clinically significant prostate cancer local recurrence after radiation therapy occurs at the site of primary tumor: magnetic resonance imaging and step-section pathology evidence","volume":"69","author":"Pucar","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2022.02.005","article-title":"Local failure after prostate SBRT predominantly occurs in the PI-RADS 4 or 5 dominant intraprostatic lesion","volume":"6","author":"Gorovets","year":"2023","journal-title":"Eur Urol Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.02873","article-title":"Focal boost to the intraprostatic tumor in external beam radiotherapy for patients with localized prostate cancer: results from the FLAME randomized phase III trial","volume":"39","author":"Kerkmeijer","year":"2021","journal-title":"J Clin Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.09.058","article-title":"Standard and hypofractionated dose escalation to intraprostatic tumor nodules in localized prostate cancer: 5-year efficacy and toxicity in the DELINEATE trial","volume":"115","author":"Tree","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110568","article-title":"Stereotactic body radiotherapy with a focal boost to the intraprostatic tumor for intermediate and high risk prostate cancer: 5-year efficacy and toxicity in the hypo-FLAME trial","volume":"201","author":"Draulans","year":"2024","journal-title":"Radiother Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.ijrobp.2024.03.009","article-title":"Simultaneous focal boost with stereotactic radiation therapy for localized intermediate- to high-risk prostate cancer: primary outcomes of the SPARC phase 2 trial","volume":"120","author":"Yasar","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2015.00077","article-title":"Stereotactic body radiation therapy for prostate cancer: what is the appropriate patient-reported outcome for clinical trial design","volume":"5","author":"Woo","year":"2015","journal-title":"Front Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.00555","article-title":"Urinary morbidity in men treated with stereotactic body radiation therapy (SBRT) for localized prostate cancer following transurethral resection of the prostate (TURP)","volume":"10","author":"Pepin","year":"2020","journal-title":"Front Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-9-163","article-title":"Obstructive voiding symptoms following stereotactic body radiation therapy for prostate cancer","volume":"9","author":"Arscott","year":"2014","journal-title":"Radiat Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"Norman","year":"2003","journal-title":"Med Care"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2018.05.001","article-title":"An investigation of dosimetric correlates of acute toxicity in prostate stereotactic body radiotherapy: dose to urinary trigone is associated with acute urinary toxicity","volume":"30","author":"Henderson","year":"2018","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.09.054","article-title":"Prostate stereotactic body radiation therapy: an overview of toxicity and dose response","volume":"110","author":"Wang","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2015.1037011","article-title":"Late urinary toxicity modeling after stereotactic body radiotherapy (SBRT) in the definitive treatment of localized prostate cancer","volume":"55","author":"Kole","year":"2016","journal-title":"Acta Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2013.08.019","article-title":"Health-related quality of life after stereotactic body radiation therapy for localized prostate cancer: results from a multi-institutional consortium of prospective trials","volume":"87","author":"King","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B17","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1007\/s00520-024-09041-w","article-title":"Female pelvic cancer survivors' experiences of pelvic floor muscle training after pelvic radiotherapy","volume":"32","author":"Lindgren","year":"2024","journal-title":"Support Care Cancer"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2025.100993","article-title":"Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost","volume":"54","author":"Bhargava","year":"2025","journal-title":"Clin Transl Radiat Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1622191\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:11:35Z","timestamp":1759205495000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1622191\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":18,"alternative-id":["10.3389\/fonc.2025.1622191"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1622191","relation":{},"ISSN":["2234-943X"],"issn-type":[{"type":"electronic","value":"2234-943X"}],"subject":[],"published":{"date-parts":[[2025,9,30]]},"article-number":"1622191"}}