Although the results on acute and late toxicity of ultrahypofractionation were encouraging, data on safety in prostate cancer patients with a history of transurethral resection of the prostate (TURP) or adenomectomy were limited, particularly in cases of repeated surgeries. For a study, researchers sought to report on long-term toxicity after stereotactic body radiotherapy (SBRT) in prostate cancer patients who had previously undergone surgical treatment for benign prostatic hyperplasia.

Data from 24 males with a history of TURP (n=19) or adenomectomy (n=5) were analyzed among 150 patients treated with SBRT (median dosage 36.25 Gy in five fractions) at a single-center institution from 2014 to 2019. Repeated TURP was performed on 3 patients, with a median interval between operation and SBRT of 54 months. Using the Common Terminology Criteria for Adverse Events v4.0 grading system, genitourinary toxicity was evaluated.

About 10 of 24 (42%) patients had at least one incident of transitory haematuria throughout the median follow-up of 45 months. A grade 3 acute non-infective cystitis was detected in 1 patient (4%) who had undergone 3 prior TURPs. There were no grade≥4 adverse events, although 8 (33%) and 4 (17%) patients (2 treated with adenomectomy, 1 treated with repeated TURP, and 1 with a 140 cm3 prostate size) experienced late grade 2 and 3 genitourinary toxicities. All patients experienced a full recovery from grade 3 genitourinary toxicity following hyperbaric oxygen treatment.

In patients with a medical history of surgical therapies for benign hyperplasia, prostate SBRT is viable and well-tolerated.