• Gregor Goldner, Richard Pötter, Alexander Kranz, Alexandra Bluhm, and Wolfgang Dörr.
• Department of Radiotherapy and Radiobiology, Vienna General Hospital, University of Vienna Medical School, Austria. Gregor.Goldner@akhwien.at
• Strahlenther Onkol. 2011 Mar 1; 187 (3): 202-5.

PurposeTo evaluate the time course of late rectal mucosal changes after prostate cancer radiotherapy (RT).Patients And MethodsA rectosigmoidoscopy was performed at 12, 24, and 65 months after RT in 20 patients. Rectal mucosal changes (telangiectasia, congested mucosa, ulceration, stricture, and necrosis) were scored and documented according to the Vienna Rectoscopy Score (VRS, score 0-3).ResultsVRS of 0 and 3, were found in 20% of patients (n = 4) and 5% of patients (n = 1), respectively at all time points. A shift of the VRS from 2 to 1 was found with incidence rates of 60% at 12 months and 20% at 65 months, which is equivalent to an improvement rate of 67%. Laser coagulation was required in 3 patients (15%) with rectal bleeding due to telangiectasia grade ≥2.ConclusionLate rectal mucosal changes are frequent after pelvic RT. Generally only the incidence rates corresponding to the initial diagnosis of the complications, independent of subsequent recovery, are reported. The results reported in the present study show that complications often improve over time. Hence, the usual reports of complication rates overestimate the proportion of patients presenting with side effects of certain grades.

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