Anorectal Function After Three- Versus Two-Dimensional Radiation Therapy for Carcinoma of the Prostate

Journal Article · Thu Jan 01 04:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.03.058· OSTI ID:21172532

Holloway, Richard H ^[1]; Fraser, Robert J ^[2]; Botten, Rochelle; Di Matteo, Addolorata ^[3]; Moore, James W ^[4]; Schoeman, Mark N ^[1]; Bartholomeusz, Dylan L ^[5]

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1. Department of Gastroenterology, Royal Adelaide Hospital, Adelaide SA (Australia)
2. Gastrointestinal Investigation Unit, Repatriation General Hospital, Daw Park, SA (Australia)
3. Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide SA (Australia)
4. Department of Colorectal Surgery, Royal Adelaide Hospital, Adelaide SA (Australia)
5. Department of Nuclear Medicine, Royal Adelaide Hospital, Adelaide SA (Australia)

Purpose: To compare the effects of (three-dimensional) 3D vs. two-dimensional (2D) radiation therapy (RT) for carcinoma of the prostate on the prevalence and pathophysiology of anorectal dysfunction. Methods and Materials: Anorectal symptoms, motility, sensory function, and anal sphincter morphology were evaluated before and up to 2 years after randomly assigned hypofractionated vs. conventionally fractionated RT in 67 patients (median age, 69 years; range, 54-82 years) with localized prostate carcinoma, using either a 3D (n = 29) or 2D (n = 38) treatment technique. Results: Anorectal symptoms increased 4 to 6 weeks after RT and persisted in both patient groups. At 2 years, abnormalities included increased stool frequency (55% vs. 53%, p = NS), urgency of defecation (72% vs. 47%, p < 0.05), fecal incontinence (28% vs. 26%, p = NS), and rectal bleeding (38% and 42%, p = NS). Anorectal motility and sensory function deteriorated after RT in both groups with reductions in basal anal pressures, anal pressures in response to squeeze, rectal compliance, and rectal volumes associated with the desire to defecate. External but not internal sphincter thickness changed in the treatment groups although in different directions. However no differences in motility or sensory function were detected between the groups. Baseline anorectal motility but not treatment technique and the hypofracionated schedule were of independent prognostic significance for anorectal motor dysfunction and rectal bleeding respectively at 2 years. Conclusion: The prevalence and pathophysiology of anorectal dysfunction 2 years after RT for prostate carcinoma was largely independent of the treatment techniques used in this study.

• OSTI ID: 21172532
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 73; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
MORPHOLOGY
PROSTATE
RADIOTHERAPY
RECTUM
SYMPTOMS