Clinical and Dosimetric Predictors of Late Rectal Syndrome After 3D-CRT for Localized Prostate Cancer: Preliminary Results of a Multicenter Prospective Study

Claudio Fiorino, Gianni Fellin, Tiziana Rancati, Vittorio Vavassori, Carla Bianchi, Valeria Casanova Borca, Giuseppe Girelli, Marco Mapelli, Loris Menegotti, Simona Nava, Riccardo Valdagni

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess the predictors of late rectal toxicity in a prospectively investigated group of patients treated at 70-80 Gy for prostate cancer (1.8-2 Gy fractions) with three-dimensional conformal radiotherapy. Methods and Materials: A total of 1,132 patients were entered into the study between 2002 and 2004. Three types of rectal toxicity, evaluated by a self-administered questionnaire, mainly based on the subjective objective management, analytic late effects of normal tissue system, were considered: stool frequency/tenesmus/pain, fecal incontinence, and bleeding. The data from 506 patients with a follow-up of 24 months were analyzed. The correlation between a number of clinical and dosimetric parameters and Grade 2 or greater toxicity was investigated by univariate and multivariate (MVA) logistic analyses. Results: Of the 1,132 patients, 21, 15, and 30 developed stool frequency/tenesmus/pain, fecal incontinence, and bleeding, respectively. Stool frequency/tenesmus/pain correlated with previous abdominal/pelvic surgery (MVA, p = 0.05, odds ratio [OR], 3.3). With regard to incontinence, MVA showed the volume receiving ≥40 Gy (V40) (p = 0.035, OR, 1.037) and surgery (p = 0.02, OR, 4.4) to be the strongest predictors. V40 to V70 were highly predictive of bleeding; V70 showed the strongest impact on MVA (p = 0.03), together with surgery (p = 0.06, OR, 2.5), which was also the main predictor of Grade 3 bleeding (p = 0.02, OR, 4.2). Conclusions: The predictive value of the dose-volume histogram was confirmed for bleeding, consistent with previously suggested constraints (V50 60 70 75 40 70

Original languageEnglish
Pages (from-to)1130-1137
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume70
Issue number4
DOIs
Publication statusPublished - Mar 15 2008

Fingerprint

bleeding
Multicenter Studies
Prostatic Neoplasms
cancer
Odds Ratio
Prospective Studies
pain
Hemorrhage
surgery
toxicity
predictions
Fecal Incontinence
Pain
grade
Conformal Radiotherapy
logistics
histograms
radiation therapy
Multivariate Analysis
dosage

Keywords

  • Conformal radiotherapy
  • Late toxicity
  • Prostate radiotherapy
  • Rectal syndrome

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Clinical and Dosimetric Predictors of Late Rectal Syndrome After 3D-CRT for Localized Prostate Cancer : Preliminary Results of a Multicenter Prospective Study. / Fiorino, Claudio; Fellin, Gianni; Rancati, Tiziana; Vavassori, Vittorio; Bianchi, Carla; Borca, Valeria Casanova; Girelli, Giuseppe; Mapelli, Marco; Menegotti, Loris; Nava, Simona; Valdagni, Riccardo.

In: International Journal of Radiation Oncology Biology Physics, Vol. 70, No. 4, 15.03.2008, p. 1130-1137.

Research output: Contribution to journalArticle

Fiorino, Claudio ; Fellin, Gianni ; Rancati, Tiziana ; Vavassori, Vittorio ; Bianchi, Carla ; Borca, Valeria Casanova ; Girelli, Giuseppe ; Mapelli, Marco ; Menegotti, Loris ; Nava, Simona ; Valdagni, Riccardo. / Clinical and Dosimetric Predictors of Late Rectal Syndrome After 3D-CRT for Localized Prostate Cancer : Preliminary Results of a Multicenter Prospective Study. In: International Journal of Radiation Oncology Biology Physics. 2008 ; Vol. 70, No. 4. pp. 1130-1137.
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AU - Rancati, Tiziana

AU - Vavassori, Vittorio

AU - Bianchi, Carla

AU - Borca, Valeria Casanova

AU - Girelli, Giuseppe

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AU - Menegotti, Loris

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KW - Conformal radiotherapy

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KW - Prostate radiotherapy

KW - Rectal syndrome

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