open access

Vol 18, No 5 (2013)
Original research articles
Published online: 2013-09-01
Submitted: 2013-02-14
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Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results

Rafael Fuentes-Raspall, José Maria Inoriza, Alvaro Rosello-Serrano, Carmen Auñón-Sanz, Pilar Garcia-Martin, Gemma Oliu-Isern
DOI: 10.1016/j.rpor.2013.05.006
·
Rep Pract Oncol Radiother 2013;18(5):298-303.

open access

Vol 18, No 5 (2013)
Original research articles
Published online: 2013-09-01
Submitted: 2013-02-14

Abstract

Aim

This study aimed at investigating factors associated to late rectal and bladder toxicity following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2.

Background

Radiation is frequently used for prostate cancer, but a 5–20% incidence of late radiation proctitis and cystitis exists. Some clinical and dosimetric factors have been defined without a full agreement. For patients diagnosed of late chronic proctitis and/or cystitis grade ≥2 treatment is not well defined. Hyperbaric Oxygen Therapy (HBOT) has been used, but its effectiveness is not well known.

Materials and methods

257 patients were treated with radiation therapy for prostate cancer. Clinical, pharmacological and dosimetric parameters were collected. Patients having a grade ≥2 toxicity were treated with HBOT. Results of the intervention were measured by monitoring toxicity by Common Toxicity Criteria v3 (CTCv3).

Results

Late rectal toxicity was related to the volume irradiated, i.e. V50[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]53.64 (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.013); V60[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]38.59% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.005); V65[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]31.09% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.002) and V70[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]22.81% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.012). We could not correlate the volume for bladder. A total of 24 (9.3%) patients experienced a grade ≥2. Only the use of dicumarinic treatment was significant for late rectal toxicity (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.014). A total of 14 patients needed HBOT. Final percentage of patients with a persistent toxicity grade ≥2 was 4.5%.

Conclusion

Rectal volume irradiated and dicumarinic treatment were associated to late rectal/bladder toxicity. When toxicity grade ≥2 is diagnosed, HBOT significantly ameliorate symptoms.

Abstract

Aim

This study aimed at investigating factors associated to late rectal and bladder toxicity following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2.

Background

Radiation is frequently used for prostate cancer, but a 5–20% incidence of late radiation proctitis and cystitis exists. Some clinical and dosimetric factors have been defined without a full agreement. For patients diagnosed of late chronic proctitis and/or cystitis grade ≥2 treatment is not well defined. Hyperbaric Oxygen Therapy (HBOT) has been used, but its effectiveness is not well known.

Materials and methods

257 patients were treated with radiation therapy for prostate cancer. Clinical, pharmacological and dosimetric parameters were collected. Patients having a grade ≥2 toxicity were treated with HBOT. Results of the intervention were measured by monitoring toxicity by Common Toxicity Criteria v3 (CTCv3).

Results

Late rectal toxicity was related to the volume irradiated, i.e. V50[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]53.64 (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.013); V60[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]38.59% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.005); V65[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]31.09% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.002) and V70[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]22.81% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.012). We could not correlate the volume for bladder. A total of 24 (9.3%) patients experienced a grade ≥2. Only the use of dicumarinic treatment was significant for late rectal toxicity (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.014). A total of 14 patients needed HBOT. Final percentage of patients with a persistent toxicity grade ≥2 was 4.5%.

Conclusion

Rectal volume irradiated and dicumarinic treatment were associated to late rectal/bladder toxicity. When toxicity grade ≥2 is diagnosed, HBOT significantly ameliorate symptoms.

Get Citation

Keywords

Rectal toxicity; Bladder toxicity; Radiotherapy; Predictive factors; Treatment; Hyperbaric oxygen

About this article
Title

Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 18, No 5 (2013)

Pages

298-303

Published online

2013-09-01

DOI

10.1016/j.rpor.2013.05.006

Bibliographic record

Rep Pract Oncol Radiother 2013;18(5):298-303.

Keywords

Rectal toxicity
Bladder toxicity
Radiotherapy
Predictive factors
Treatment
Hyperbaric oxygen

Authors

Rafael Fuentes-Raspall
José Maria Inoriza
Alvaro Rosello-Serrano
Carmen Auñón-Sanz
Pilar Garcia-Martin
Gemma Oliu-Isern

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