• Edy Ippolito, Francesco Deodato, Gabriella Macchia, Mariangela Massaccesi, Cinzia Digesù, Giuseppe A Pirozzi, Gianluca Spera, Stefania Marangi, Emanuele Annoscia, Savino Cilla, Angelo Piermattei, Vincenzo Valentini, Numa Cellini, Marcello Ingrosso, and Alessio Giuseppe Morganti.
• Fondazione di Ricerca e Cura Giovanni Paolo II, Università Cattolica del S. Cuore, Campobasso, Italy.
• Radiother Oncol. 2012 Jul 1; 104 (1): 103-8.

Background And PurposeLate rectal complications are assessed according to different scoring systems. Endoscopy can provide a more sensitive estimation of early radiation damage. The aim of this paper is to investigate the correlation between dosimetric parameters and rectal mucosal changes after radiotherapy (RT).Materials And MethodsPatients with prostate adenocarcinoma treated with curative or adjuvant RT underwent endoscopy 1 year after RT. Receiver operating characteristics (ROC) analysis was performed to analyze the predictive capability of the dosimetric variables in determining mucosal changes classified by Vienna Rectoscopy Score (VRS).ResultsThe best dosimetric predictors of grade ≥2 telangiectasia were rectal (r) V(60 Gy) (p=0.014), rV(70 Gy) (p=0.017) and rD(mean) (p=0.018). Similar results were obtained for grade ≥2 VRS. The set of rV(60 Gy)<34.4%, rV(70 Gy)<16.7% and rD(mean)<57.5 Gy was associated with a decreased risk of grade ≥2 telangiectasia and VRS.ConclusionsrV(60 Gy), rV(70 Gy) and rD(mean) were the strongest predictors of rectal mucosal alterations. In-depth analysis is required to correlate each mucosal alteration with late rectal toxicity in order to suggest early proctoscopy as surrogate end-point for rectal late toxicity in studies aimed at reducing this important complication.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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