• Radiother Oncol · Feb 2014

    Long term rectal function after high-dose prostatecancer radiotherapy: results from a prospective cohort study.

    • Gianni Fellin, Tiziana Rancati, Claudio Fiorino, Vittorio Vavassori, Paolo Antognoni, Michela Baccolini, Carla Bianchi, Emanuela Cagna, BorcaValeria CasanovaVCDepartment of Medical Physics, Ospedale ASL 9, Ivrea, Italy., Giuseppe Girelli, Bruno Iacopino, Giuseppe Maliverni, Flora A Mauro, Loris Menegotti, Angelo F Monti, Fabrizio Romani, Michele Stasi, and Riccardo Valdagni.
    • Department of Radiotherapy, Ospedale Santa Chiara, Trento, Italy.
    • Radiother Oncol. 2014 Feb 1; 110 (2): 272-7.

    PurposeTo prospectively evaluate long-term late rectal bleeding (lrb) and faecal incontinence (linc) after high-dose radiotherapy (RT) for prostate cancer in the AIROPROS 0102 population, and to assess clinical/dosimetric risk factors.Materials And MethodsQuestionnaires of 515 patients with G0 baseline incontinence and bleeding scores (follow-up ≥6 years) were analysed. Correlations between lrb/linc and many clinical and dosimetric parameters were investigated by univariate and multivariate logistic analyses. The correlation between lrb/linc and symptoms during the first 3 years after RT was also investigated.ResultsOf 515 patients lrb G1, G2 and G3 was found in 32 (6.1%), 2 (0.4%) and 3 (0.6%) patients while linc G1, G2 and G3 was detected in 50 (9.7%), 3 (0.6%) and 3 (0.6%), respectively. The prevalence of G2-G3 lrb events was significantly reduced compared to the first 3-years (1% vs 2.7%, p=0.016) ≥G1 lrb was significantly associated with V75 Gy (OR=1.07). In multivariate analysis, ≥G1 linc was associated with V40 Gy (OR=1.015), use of antihypertensive medication (OR=0.38), abdominal surgery before RT (OR=4.7), haemorrhoids (OR=2.6), and G2-G3 acute faecal incontinence (OR=4.4), a nomogram to predict the risk of long-term ≥G1 linc was proposed. Importantly, the prevalence of ≥G1 linc was significantly correlated with the mean incontinence score during the first 3 years after RT (OR=16.3).ConclusionsLong-term (median: 7 years) rectal symptoms are prevalently mild and strongly correlated with moderate/severe events occurring in the first 3 years after RT. Linc was associated with several risk factors.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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