• Valérie Fonteyne, Wilfried De Neve, Geert Villeirs, Carlos De Wagter, and Gert De Meerleer.
• Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium. fonteynevalerie@hotmail.com
• Radiother Oncol. 2007 Aug 1; 84 (2): 156-63.

PurposeTo report on: 1. Late radiotherapy-induced lower intestinal toxicity (RILIT) after intensity-modulated radiotherapy (IMRT) for prostate cancer. 2. The correlation between late RILIT and volume parameters of the rectum, sigmoid colon and small bowel.Materials And MethodsWe included 241 patients with a follow-up of >or=18 months for this analysis. Late RILIT consisted of 8 different symptoms, comprising the 5 symptoms from the RTOG toxicity score supplemented with urgency, fecal incontinence and anal pain. Late RILIT and late RTOG toxicity were scored prospectively and correlated with: 1. Different rectum, sigmoid colon and small bowel volume parameters. 2. Patient-related morbidity. We calculated the median, quartile and percentiles for the different volume parameters and correlated them with grade 1-3 late RILIT.ResultsMedian follow-up was 42 months. Three patients developed grade 3 red blood loss. We registered grade 2 RILIT and RTOG toxicity in 13% and 10%, respectively, the most frequent grade 1 symptom being fecal urgency. The intermediate rectal volume parameters were significantly correlated with late RILIT. We were able to calculate cut-off dose-volume histograms (DVHs) that predict for grade 0-2 RILIT.ConclusionsAfter IMRT for prostate cancer, the overall incidence of grade >or=2 RILIT is low. Cut-off DVHs can be used for patient counseling.

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