Reduced late rectal mucosal changes after prostate three-dimensional conformal radiotherapy with endorectal balloon as observed in repeated endoscopy

Journal Article · Thu Mar 01 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.09.034· OSTI ID:20944732

Lin, Emile van ^[1]; Kristinsson, Jon ^[2]; Philippens, Marielle E.P. ^[1]; Jong, Dirk J. de ^[2]; Vight, Lisette P. van der ^[1]; Kaanders, Johannes ^[1]; Leer, Jan Willem ^[1]; Visser, Andries G ^[1]

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1. Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)
2. Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

Purpose: The aim of this study was to investigate prospectively the rectal wall (Rwall) spatial dose distribution, toxicity, and mucosal changes after prostate cancer radiotherapy with or without an endorectal balloon (ERB). Methods and Materials: A total of 24 patients with ERB and 24 without ERB (No-ERB) were treated with three-dimensional conformal radiotherapy (3D-CRT) to a dose of 67.5 Gy. The Rwall was divided into 16 mucosal areas and Rwall dose surface maps were constructed. After 3 months, 6 months, 1 year, and 2 years a rectosigmoidoscopy was performed, and each mucosal area was scored on telangiectasia, congestion, ulceration, stricture, and necrosis. Late rectal toxicity was correlated with the endoscopic findings. Results: The ERB significantly reduced the Rwall volume exposed to doses >40 Gy. Late rectal toxicity (grade {>=}1, including excess of bowel movements and slight rectal discharge) was reduced significantly in the ERB group. A total of 146 endoscopies and 2,336 mucosal areas were analyzed. Telangiectases were most frequently seen and appeared after 6 months. At 1 and 2 years, significantly less high-grade telangiectasia (T 2-3) was observed in the ERB group at the lateral and posterior part of the Rwall. In mucosal areas exposed to doses >40 Gy, less high-grade telangiectases (T 2-3) were seen in the ERB group compared with the No-ERB group. Conclusions: An ERB reduced the Rwall volume exposed to doses >40 Gy, resulting in reduction of late rectal mucosal changes and reduced late rectal toxicity. Although further analysis is needed, these data suggest an ERB-induced increased tolerance for late Rwall damage.

• OSTI ID: 20944732
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BALLOONS
CARCINOMAS
NECROSIS
PATIENTS
PROSTATE
RADIATION DOSES
RADIOTHERAPY
RECTUM
SPATIAL DOSE DISTRIBUTIONS
TOXICITY