• Gregor Goldner, Birgit Tomicek, Gerd Becker, Hans Geinitz, Stefan Wachter, Frank Zimmermann, Natascha Wachter-Gerstner, Jochen Reibenwein, Stefan Glocker, Michael Bamberg, Horst Feldmann, Regina Pötzi, Michael Molls, and Richard Pötter.
• Department of Radiotherapy and Radiobiology, Vienna General Hospital, University of Vienna Medical School, Vienna, Austria. Gregor.Goldner@akhwien.at
• Int. J. Radiat. Oncol. Biol. Phys. 2007 Jan 1; 67 (1): 78-83.

PurposeTo evaluate the Vienna Rectoscopy Score (VRS) as a feasible and effective tool for detecting and classifying pathologic changes in the rectal mucosa after radiotherapy (RT) for prostate cancer, and, also, to correlate its findings with the European Organization for Research and Treatment of Cancer (EORTC)/Radiation Therapy Oncology Group (RTOG) score for late rectal toxicity.Methods And MaterialsA total of 486 patients with localized prostate cancer underwent external-beam RT up to 70 or 74 Gy within an Austrian-German prospective multicenter trial. In 166 patients, voluntary rectal sigmoidoscopy was performed before and at 12 and/or 24 months after RT. Pathologic findings such as telangiectasia, congested mucosa, and ulcers were graded (Grades 0-3) and summarized according to the VRS. Late rectal side effects (EORTC/RTOG) were documented and correlated with the corresponding VRS.ResultsBefore RT, 99% had a VRS score of 0. The median follow-up was 40 months. Overall, a late rectal side effects grade or score 1-3 was detected in 43% by EORTC/RTOG compared with 68% by VRS (p < 0.05). Grades 0, 1, 2, and 3 late rectal side effects were found using EORTC/RTOG in 57%, 11%, 28%, and 3%, respectively; the corresponding percentages were 32%, 22%, 32%, and 14% for a VRS of 0, 1, 2, and 3, respectively. A significant coherence between the VRS and EORTC/RTOG was found (p < 0.01).ConclusionsThe VRS is a feasible and effective tool for describing and classifying pathologic findings in the rectal mucosa after RT within a multicenter trial. The VRS and EORTC/RTOG showed a high coherence. However the VRS was significantly more sensitive.

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