skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Rectal Toxicity After Proton Therapy For Prostate Cancer: An Analysis of Outcomes of Prospective Studies Conducted at the University of Florida Proton Therapy Institute

Abstract

Purpose: Study goals were to characterize gastrointestinal effects of proton therapy (PT) in a large cohort of patients treated for prostate cancer, identify factors associated with rectal bleeding (RB), and compare RB between patients receiving investigational protocols versus those in outcome-tracking protocols. Methods and Materials: A total of 1285 consecutive patients were treated with PT between August 2006 and May 2010. Potential pre-existing clinical and treatment-related risk factors for rectal toxicity were recorded. Common Terminology Criteria for Adverse Events version 3.0 was used to score toxicity. Results: Transient RB was the predominant grade 2 or higher (GR2+) toxicity after PT, accounting for 95% of gastrointestinal events. GR1 RB occurred in 217 patients (16.9%), GR2 RB in 187 patients (14.5%), and GR3 in 11 (0.9%) patients. There were no GR4 or GR5 events. Univariate analyses showed correlations between GR2+ RB and anticoagulation therapy (P=.008) and rectal and rectal wall dose-volume histogram (DVH) parameters (P<.001). On multivariate analysis, anticoagulation therapy (P=.0034), relative volume of rectum receiving 75 Gy (V75; P=.0102), and relative rectal wall V75 (P=.0017) were significant predictors for G2+ RB. Patients treated with investigational protocols had toxicity rates similar to those receiving outcome-tracking protocols. Conclusions: PT was associated with a low ratemore » of GR2+ gastrointestinal toxicity, predominantly transient RB, which was highly correlated with anticoagulation and rectal DVH parameters. Techniques that limit rectal exposure should be used when possible.« less

Authors:
; ;  [1];  [2]; ; ; ; ; ;  [1];  [2];  [1]
  1. The University of Florida Proton Therapy Institute, Jacksonville, Florida (United States)
  2. Baptist Health Medical Center, Department of Surgery, Jacksonville, Florida (United States)
Publication Date:
OSTI Identifier:
22423853
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 91; Journal Issue: 1; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPARATIVE EVALUATIONS; EDUCATIONAL FACILITIES; FLORIDA; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; PROSTATE; PROTON BEAMS; RADIATION DOSES; RADIOTHERAPY; RECTUM; TOXICITY

Citation Formats

Colaco, Rovel J., Hoppe, Bradford S., Flampouri, Stella, McKibben, Brian T., Henderson, Randal H., Bryant, Curtis, Nichols, Romaine C., Mendenhall, William M., Li, Zuofeng, Su, Zhong, Morris, Christopher G., and Mendenhall, Nancy P., E-mail: menden@floridaproton.org. Rectal Toxicity After Proton Therapy For Prostate Cancer: An Analysis of Outcomes of Prospective Studies Conducted at the University of Florida Proton Therapy Institute. United States: N. p., 2015. Web. doi:10.1016/J.IJROBP.2014.08.353.
Colaco, Rovel J., Hoppe, Bradford S., Flampouri, Stella, McKibben, Brian T., Henderson, Randal H., Bryant, Curtis, Nichols, Romaine C., Mendenhall, William M., Li, Zuofeng, Su, Zhong, Morris, Christopher G., & Mendenhall, Nancy P., E-mail: menden@floridaproton.org. Rectal Toxicity After Proton Therapy For Prostate Cancer: An Analysis of Outcomes of Prospective Studies Conducted at the University of Florida Proton Therapy Institute. United States. doi:10.1016/J.IJROBP.2014.08.353.
Colaco, Rovel J., Hoppe, Bradford S., Flampouri, Stella, McKibben, Brian T., Henderson, Randal H., Bryant, Curtis, Nichols, Romaine C., Mendenhall, William M., Li, Zuofeng, Su, Zhong, Morris, Christopher G., and Mendenhall, Nancy P., E-mail: menden@floridaproton.org. Thu . "Rectal Toxicity After Proton Therapy For Prostate Cancer: An Analysis of Outcomes of Prospective Studies Conducted at the University of Florida Proton Therapy Institute". United States. doi:10.1016/J.IJROBP.2014.08.353.
@article{osti_22423853,
title = {Rectal Toxicity After Proton Therapy For Prostate Cancer: An Analysis of Outcomes of Prospective Studies Conducted at the University of Florida Proton Therapy Institute},
author = {Colaco, Rovel J. and Hoppe, Bradford S. and Flampouri, Stella and McKibben, Brian T. and Henderson, Randal H. and Bryant, Curtis and Nichols, Romaine C. and Mendenhall, William M. and Li, Zuofeng and Su, Zhong and Morris, Christopher G. and Mendenhall, Nancy P., E-mail: menden@floridaproton.org},
abstractNote = {Purpose: Study goals were to characterize gastrointestinal effects of proton therapy (PT) in a large cohort of patients treated for prostate cancer, identify factors associated with rectal bleeding (RB), and compare RB between patients receiving investigational protocols versus those in outcome-tracking protocols. Methods and Materials: A total of 1285 consecutive patients were treated with PT between August 2006 and May 2010. Potential pre-existing clinical and treatment-related risk factors for rectal toxicity were recorded. Common Terminology Criteria for Adverse Events version 3.0 was used to score toxicity. Results: Transient RB was the predominant grade 2 or higher (GR2+) toxicity after PT, accounting for 95% of gastrointestinal events. GR1 RB occurred in 217 patients (16.9%), GR2 RB in 187 patients (14.5%), and GR3 in 11 (0.9%) patients. There were no GR4 or GR5 events. Univariate analyses showed correlations between GR2+ RB and anticoagulation therapy (P=.008) and rectal and rectal wall dose-volume histogram (DVH) parameters (P<.001). On multivariate analysis, anticoagulation therapy (P=.0034), relative volume of rectum receiving 75 Gy (V75; P=.0102), and relative rectal wall V75 (P=.0017) were significant predictors for G2+ RB. Patients treated with investigational protocols had toxicity rates similar to those receiving outcome-tracking protocols. Conclusions: PT was associated with a low rate of GR2+ gastrointestinal toxicity, predominantly transient RB, which was highly correlated with anticoagulation and rectal DVH parameters. Techniques that limit rectal exposure should be used when possible.},
doi = {10.1016/J.IJROBP.2014.08.353},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 91,
place = {United States},
year = {Thu Jan 01 00:00:00 EST 2015},
month = {Thu Jan 01 00:00:00 EST 2015}
}