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
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
相关论文
共 44 条
[1]   Gastrointestinal symptoms after pelvic radiotherapy: Role for the gastroenterologist? [J].
Andreyev, HJN ;
Vlavianos, P ;
Blake, P ;
Dearnaley, D ;
Norman, AR ;
Tait, D .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2005, 62 (05) :1464-1471
[2]   Gastrointestinal symptoms after pelvic radiotherapy: a new understanding to improve management of symptomatic patients [J].
Andreyev, Jervoise .
LANCET ONCOLOGY, 2007, 8 (11) :1007-1017
[3]  
[Anonymous], 1995, Radiother Oncol, V35, P17
[4]   Estimation of the incidence of late bladder and rectum complications after high-dose (70-78 Gy) conformal radiotherapy for prostate cancer, using dose-volume histograms [J].
Boersma, LJ ;
van den Brink, M ;
Bruce, AM ;
Shouman, T ;
Gras, L ;
te Velde, A ;
Lebesque, JV .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1998, 41 (01) :83-92
[5]   Is there more than one proctitis syndrome? A revisitation using data from the TROG 96.01 trial [J].
Capp, Anne ;
Inostroza-Ponta, Mario ;
Bill, Dana ;
Moscato, Pablo ;
Lai, Chi ;
Christie, David ;
Lamb, David ;
Turner, Sandra ;
Joseph, David ;
Matthews, John ;
Atkinson, Chris ;
North, John ;
Poulsen, Michael ;
Spry, Nigel A. ;
Tai, Keen-Hun ;
Wynne, Chris ;
Duchesne, Gillian ;
Steigler, Allison ;
Denham, James W. .
RADIOTHERAPY AND ONCOLOGY, 2009, 90 (03) :400-407
[6]  
Chi KD, 2005, J CLIN GASTROENTEROL, V39, P42
[7]   Delayed rectal and urinary symptomatotogy in patients treated for prostate cancer by radiotherapy with or without short term neo-adjuvant androgen deprivation [J].
Christie, D ;
Denham, J ;
Steigler, A ;
Lamb, D ;
Turner, S ;
Mameghan, H ;
Joseph, D ;
Matthews, J ;
Franklin, I ;
Atkinson, C ;
North, J ;
Poulsen, M ;
Spry, NA ;
Tai, KH ;
Wynne, C ;
Duchesne, G ;
Kovacev, O ;
Francis, L ;
Kramar, A ;
D'Este, C ;
Bill, D .
RADIOTHERAPY AND ONCOLOGY, 2005, 77 (02) :117-125
[8]   TOXICITY CRITERIA OF THE RADIATION-THERAPY ONCOLOGY GROUP (RTOG) AND THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER (EORTC) [J].
COX, JD ;
STETZ, J ;
PAJAK, TF .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (05) :1341-1346
[9]   Significant correlation between rectal DVH and late bleeding in patients treated after radical prostatectomy with conformal or conventional radiotherapy (66.6-70.2 GY) [J].
Cozzarini, C ;
Fiorino, C ;
Ceresoli, GL ;
Cattaneo, GM ;
Bolognesi, A ;
Calandrino, R ;
Villa, E .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2003, 55 (03) :688-694
[10]  
Crespi M, 1996, AM J GASTROENTEROL, V91, P191