Early radiation-induced mucosal changes evaluated by proctoscopy: Predictive role of dosimetric parameters

被引：10
作者：
Ippolito, Edy
Deodato, Francesco
Macchia, Gabriella [1 ]
Massaccesi, Mariangela
Digesu, Cinzia
Pirozzi, Giuseppe A.
Spera, Gianluca
Marangi, Stefania
Annoscia, Emanuele
Cilla, Savino
Piermattei, Angelo
Valentini, Vincenzo [2 ]
Cellini, Numa [2 ]
Ingrosso, Marcello
Morganti, Alessio Giuseppe [2 ]
机构：
[1] Univ Cattolica S Cuore, Radiat Oncol Unit, Fdn Ric & Cura Giovanni Paolo II, I-86100 Campobasso, Italy
[2] Univ Cattolica S Cuore, Policlin Univ A Gemelli, Rome, Italy
来源：
RADIOTHERAPY AND ONCOLOGY | 2012年 / 104卷 / 01期
关键词：
Prostate cancer; Rectoscopy; Late rectal toxicity; LATE RECTAL TOXICITY; PROSTATE-CANCER; CONFORMAL RADIOTHERAPY; PROCTITIS; THERAPY; MULTICENTER; 3D-CRT;
D O I：
10.1016/j.radonc.2012.05.010
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Background and purpose: Late 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 methods: Patients 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). Results: The 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. Conclusions: rV(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. (C) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 104 (2012) 103-108
引用
收藏
页码：103 / 108
页数：6
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