• Edy Ippolito, Mariangela Massaccesi, Cinzia Digesù, Francesco Deodato, Gabriella Macchia, Giuseppe Antonio Pirozzi, Savino Cilla, Daniele Cuscunà, Alessandra Di Lallo, Gian Carlo Mattiucci, Giovanna Mantini, Fabio Pacelli, Vincenzo Valentini, Numa Cellini, Marcello Ingrosso, and Alessio Giuseppe Morganti.
• Radiotherapy Unit, Fondazione di Ricerca e Cura Giovanni Paolo II, Università Cattolica del S Cuore, Campobasso, Italy.
• Int. J. Radiat. Oncol. Biol. Phys. 2012 Jun 1; 83 (2): e191-5.

PurposeTo predict the grade and incidence of late clinical rectal toxicity through short-term (1 year) mucosal alterations.Methods And MaterialsPatients 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.ResultsAfter 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.ConclusionsEarly 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.Copyright © 2012 Elsevier Inc. All rights reserved.

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