Long term rectal function after high-dose prostatecancer radiotherapy: Results from a prospective cohort study

Gianni Fellin, Tiziana Rancati, Claudio Fiorino, Vittorio Vavassori, Paolo Antognoni, Michela Baccolini, Carla Bianchi, Emanuela Cagna, Valeria Casanova Borca, Giuseppe Girelli, Bruno Iacopino, Giuseppe Maliverni, Flora A. Mauro, Loris Menegotti, Angelo F. Monti, Fabrizio Romani, Michele Stasi, Riccardo Valdagni

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)272-277
Number of pages6
JournalRadiotherapy and Oncology
Volume110
Issue number2
DOIs
Publication statusPublished - 2014

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Keywords

  • Dose-volume effects
  • Late toxicity
  • Normal tissue complication probability modeling
  • Prostate cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology
  • Medicine(all)

Cite this

Fellin, G., Rancati, T., Fiorino, C., Vavassori, V., Antognoni, P., Baccolini, M., Bianchi, C., Cagna, E., Borca, V. C., Girelli, G., Iacopino, B., Maliverni, G., Mauro, F. A., Menegotti, L., Monti, A. F., Romani, F., Stasi, M., & Valdagni, R. (2014). Long term rectal function after high-dose prostatecancer radiotherapy: Results from a prospective cohort study. Radiotherapy and Oncology, 110(2), 272-277. https://doi.org/10.1016/j.radonc.2013.09.028