Assessment of lower urinary tract symptoms and their impact on quality of life following radiation therapy for bladder cancer.

Background: Radiation therapy is a common treatment modality for muscle-invasive bladder cancer (BC). Unfortunately, approximately 5 - 10% of treated patients suffer from long-term complications, such as radiation cystitis. While radiation cystitis initially causes urinary symptoms, it can progress to chronic late effects over time. This treatment may have significant physical and psychological implications for cancer survivors. Methods: This prospective, observational multicenter study was conducted in Denmark from 2020 to 2023. Male patients undergoing radiation treatment for BC were included and stratified into two groups based on radiation strategy: 64 Gy/32 fractions versus 36 Gy/6 fractions. Patients completed baseline and follow-up questionnaires assessing lower urinary tract symptoms and quality of life (QoL). Results: A total of 26 patients were enrolled into the study, with three patients withdrawing consent. Eleven patients were assigned to the 64 Gy/32 fraction group and 12 to the 36 Gy/6 fraction group. At baseline, patients receiving 64 Gy/32 fraction reported a lower impact on QoL, with a median (interquartile range [IQR]) score of 2 (24) compared to 20 (27) in the 36 Gy/6 fraction group. At the 4-month follow-up, the median (IQR) total QoL score was 25 (27) in the 64 Gy 32 fraction group and 6 (14) in the 36 Gy/6 fraction group. At 12 months, the scores were 16 (35) and 3 (3), respectively. Conclusion: These findings suggest that the total radiation dose has a greater impact on urinary symptoms and QoL than the fractionation strategy. However, due to the low inclusion rate, these findings should be interpreted with caution.