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 ⩾6years) 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 3years 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 3years after RT (OR=16.3).
CONCLUSIONS: Long-term (median: 7years) rectal symptoms are prevalently mild and strongly correlated with moderate/severe events occurring in the first 3years after RT. Linc was associated with several risk factors.
Written by:
Fellin G, Rancati T, Fiorino C, Vavassori V, Antognoni P, Baccolini M, Bianchi C, Cagna E, Borca VC, Girelli G, Iacopino B, Maliverni G, Mauro FA, Menegotti L, Monti AF, Romani F, Stasi M, Valdagni R. Are you the author?
Department of Radiotherapy, Ospedale Santa Chiara, Trento, Italy; Prostate Cancer Program, Ospedale San Raffaele, Milan, Italy; Department of Medical Physics, Milan, Italy; Department of Radiotherapy, Ospedale di Circolo, Varese, Italy; Department of Medical Physics, Ospedale Villa Maria Cecilia, Lugo di Romagna, Italy; Department of Medical Physics, Ospedale di Circolo, Varese, Italy; Department of Radiotherapy, Ospedale Sant'Anna, Como, Italy; Department of Medical Physics, Ospedale ASL 9, Ivrea, Italy; Department of Radiotherapy, Ospedale ASL 9, Ivrea, Italy; Department of Radiotherapy, Policlinico Sant'Orsola Malpighi, Bologna, Italy; Department of Radiotherapy, IRCC Candiolo, Italy; Department of Radiotherapy, Ospedale Villa Maria Cecilia, Lugo di Romagna, Italy; Department of Medical Physics, Ospedale Santa Chiara, Trento, Italy; Department of Medical Physics, Ospedale Sant'Anna, Como, Italy; Department of Medical Physics, Policlinico Sant'Orsola Malpighi Bologna, Italy; Department of Medical Physics, IRCC Candiolo, Italy; Prostate Cancer Program, Ospedale San Raffaele, Milan, Italy; Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Reference: Radiother Oncol. 2013 Dec 11. pii: S0167-8140(13)00585-9.
doi: 10.1016/j.radonc.2013.09.028
PubMed Abstract
PMID: 24332020
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