TY - JOUR
T1 - Long term rectal function after high-dose prostatecancer radiotherapy
T2 - Results from a prospective cohort study
AU - Fellin, Gianni
AU - Rancati, Tiziana
AU - Fiorino, Claudio
AU - Vavassori, Vittorio
AU - Antognoni, Paolo
AU - Baccolini, Michela
AU - Bianchi, Carla
AU - Cagna, Emanuela
AU - Borca, Valeria Casanova
AU - Girelli, Giuseppe
AU - Iacopino, Bruno
AU - Maliverni, Giuseppe
AU - Mauro, Flora A.
AU - Menegotti, Loris
AU - Monti, Angelo F.
AU - Romani, Fabrizio
AU - Stasi, Michele
AU - Valdagni, Riccardo
PY - 2014
Y1 - 2014
N2 - Purpose To prospectively evaluate long-term late rectal bleeding (lrb) and faecal incontinence (linc) after high-dose radiotherapy (RT) for prostate cancer in the AIROPROS 0102 population, and to assess clinical/dosimetric risk factors. Materials and methods Questionnaires of 515 patients with G0 baseline incontinence and bleeding scores (follow-up ≥6 years) were analysed. Correlations between lrb/linc and many clinical and dosimetric parameters were investigated by univariate and multivariate logistic analyses. The correlation between lrb/linc and symptoms during the first 3 years after RT was also investigated. Results Of 515 patients lrb G1, G2 and G3 was found in 32 (6.1%), 2 (0.4%) and 3 (0.6%) patients while linc G1, G2 and G3 was detected in 50 (9.7%), 3 (0.6%) and 3 (0.6%), respectively. The prevalence of G2-G3 lrb events was significantly reduced compared to the first 3-years (1% vs 2.7%, p = 0.016) ≥G1 lrb was significantly associated with V75Gy (OR = 1.07). In multivariate analysis, ≥G1 linc was associated with V40Gy (OR = 1.015), use of antihypertensive medication (OR = 0.38), abdominal surgery before RT (OR = 4.7), haemorrhoids (OR = 2.6), and G2-G3 acute faecal incontinence (OR = 4.4), a nomogram to predict the risk of long-term ≥G1 linc was proposed. Importantly, the prevalence of ≥G1 linc was significantly correlated with the mean incontinence score during the first 3 years after RT (OR = 16.3). Conclusions Long-term (median: 7 years) rectal symptoms are prevalently mild and strongly correlated with moderate/severe events occurring in the first 3 years after RT. Linc was associated with several risk factors.
AB - Purpose To prospectively evaluate long-term late rectal bleeding (lrb) and faecal incontinence (linc) after high-dose radiotherapy (RT) for prostate cancer in the AIROPROS 0102 population, and to assess clinical/dosimetric risk factors. Materials and methods Questionnaires of 515 patients with G0 baseline incontinence and bleeding scores (follow-up ≥6 years) were analysed. Correlations between lrb/linc and many clinical and dosimetric parameters were investigated by univariate and multivariate logistic analyses. The correlation between lrb/linc and symptoms during the first 3 years after RT was also investigated. Results Of 515 patients lrb G1, G2 and G3 was found in 32 (6.1%), 2 (0.4%) and 3 (0.6%) patients while linc G1, G2 and G3 was detected in 50 (9.7%), 3 (0.6%) and 3 (0.6%), respectively. The prevalence of G2-G3 lrb events was significantly reduced compared to the first 3-years (1% vs 2.7%, p = 0.016) ≥G1 lrb was significantly associated with V75Gy (OR = 1.07). In multivariate analysis, ≥G1 linc was associated with V40Gy (OR = 1.015), use of antihypertensive medication (OR = 0.38), abdominal surgery before RT (OR = 4.7), haemorrhoids (OR = 2.6), and G2-G3 acute faecal incontinence (OR = 4.4), a nomogram to predict the risk of long-term ≥G1 linc was proposed. Importantly, the prevalence of ≥G1 linc was significantly correlated with the mean incontinence score during the first 3 years after RT (OR = 16.3). Conclusions Long-term (median: 7 years) rectal symptoms are prevalently mild and strongly correlated with moderate/severe events occurring in the first 3 years after RT. Linc was associated with several risk factors.
KW - Dose-volume effects
KW - Late toxicity
KW - Normal tissue complication probability modeling
KW - Prostate cancer
KW - Radiotherapy
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U2 - 10.1016/j.radonc.2013.09.028
DO - 10.1016/j.radonc.2013.09.028
M3 - Article
C2 - 24332020
AN - SCOPUS:84896400424
VL - 110
SP - 272
EP - 277
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 2
ER -