Early Proctoscopy is a Surrogate Endpoint of Late Rectal Toxicity in Prostate Cancer Treated With Radiotherapy

Journal Article · Fri Jun 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2011.12.046· OSTI ID:22056403

Ippolito, Edy; Massaccesi, Mariangela; Digesu, Cinzia; Deodato, Francesco ^[1]; Macchia, Gabriella ^[1]; Pirozzi, Giuseppe Antonio ^[2]; Cilla, Savino ^[3]; Cuscuna, Daniele; Di Lallo, Alessandra ^[4]; Mattiucci, Gian Carlo; Mantini, Giovanna ^[5]; Pacelli, Fabio ^[6]; Valentini, Vincenzo; Cellini, Numa ^[5]; Ingrosso, Marcello ^[2]; Morganti, Alessio Giuseppe ^[1]

---

1. Radiotherapy Unit, Fondazione di Ricerca e Cura Giovanni Paolo II, Universita Cattolica del S. Cuore, Campobasso (Italy)
2. Endoscopy Unit, Fondazione di Ricerca e Cura Giovanni Paolo II, Universita Cattolica del S. Cuore, Campobasso (Italy)
3. Medical Physics Unit, Fondazione di Ricerca e Cura Giovanni Paolo II, Universita Cattolica del S. Cuore, Campobasso (Italy)
4. Urology Unit, General Hospital A. Cardarelli, Campobasso (Italy)
5. Department of Radiotherapy, Policlinico Universitario Agostino Gemelli, Universita Cattolica del S. Cuore, Rome (Italy)
6. Surgery Unit, Fondazione di Ricerca e Cura Giovanni Paolo II, Universita Cattolica del S. Cuore, Campobasso (Italy)

Purpose: To predict the grade and incidence of late clinical rectal toxicity through short-term (1 year) mucosal alterations. Methods and Materials: Patients with prostate adenocarcinoma treated with curative or adjuvant radiotherapy underwent proctoscopy a year after the course of radiotherapy. Mucosal changes were classified by the Vienna Rectoscopy Score (VRS). Late toxicity data were analyzed according to the Kaplan-Meier method. Comparison between prognosis groups was performed by log-rank analysis. Results: After a median follow-up time of 45 months (range, 18-99), the 3-year incidence of grade {>=}2 rectal late toxicity according to the criteria of the European Organization for Research and Treatment of Cancer and the Radiation Therapy Oncology Group was 24%, with all patients (24/24; 100%) experiencing rectal bleeding. The occurrence of grade {>=}2 clinical rectal late toxicity was higher in patients with grade {>=}2 (32% vs. 15 %, p = 0.02) or grade {>=}3 VRS telangiectasia (47% vs. 17%, p {<=} 0.01) and an overall VRS score of {>=}2 (31% vs. 16 %, p = 0.04) or {>=}3 (48% vs. 17%, p = 0.01) at the 1-year proctoscopy. Conclusions: Early proctoscopy (1 year) predicts late rectal bleeding and therefore can be used as a surrogate endpoint for late rectal toxicity in studies aimed at reducing this frequent complication.

• OSTI ID: 22056403
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 83; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
PATIENTS
PROSTATE
RADIOTHERAPY
RECTUM
TOXICITY