PURPOSE: To predict the grade and incidence of late clinical rectal toxicity through short-term (1 year) mucosal alterations. METHODS AND MATERIALS: Patients with prostate adenocarcinoma treated with curative or adjuvant radiotherapy underwent proctoscopy a year after the course of radiotherapy. Mucosal changes were classified by the Vienna Rectoscopy Score (VRS). Late toxicity data were analyzed according to the Kaplan-Meier method. Comparison between prognosis groups was performed by log-rank analysis. RESULTS: After a median follow-up time of 45 months (range, 18-99), the 3-year incidence of grade ≥ 2 rectal late toxicity according to the criteria of the European Organization for Research and Treatment of Cancer and the Radiation Therapy Oncology Group was 24%, with all patients (24/24; 100%) experiencing rectal bleeding. The occurrence of grade ≥ 2 clinical rectal late toxicity was higher in patients with grade ≥ 2 (32% vs. 15 %, p = 0.02) or grade ≥ 3 VRS telangiectasia (47% vs. 17%, p ≤ 0.01) and an overall VRS score of ≥ 2 (31% vs. 16 %, p = 0.04) or ≥ 3 (48% vs. 17%, p = 0.01) at the 1-year proctoscopy. CONCLUSIONS: Early proctoscopy (1 year) predicts late rectal bleeding and therefore can be used as a surrogate endpoint for late rectal toxicity in studies aimed at reducing this frequent complication.
PURPOSE: To predict the grade and incidence of late clinical rectal toxicity through short-term (1 year) mucosal alterations. METHODS AND MATERIALS: Patients with prostate adenocarcinoma treated with curative or adjuvant radiotherapy underwent proctoscopy a year after the course of radiotherapy. Mucosal changes were classified by the Vienna Rectoscopy Score (VRS). Late toxicity data were analyzed according to the Kaplan-Meier method. Comparison between prognosis groups was performed by log-rank analysis. RESULTS: After a median follow-up time of 45 months (range, 18-99), the 3-year incidence of grade ≥ 2 rectal late toxicity according to the criteria of the European Organization for Research and Treatment of Cancer and the Radiation Therapy Oncology Group was 24%, with all patients (24/24; 100%) experiencing rectal bleeding. The occurrence of grade ≥ 2 clinical rectal late toxicity was higher in patients with grade ≥ 2 (32% vs. 15 %, p = 0.02) or grade ≥ 3 VRS telangiectasia (47% vs. 17%, p ≤ 0.01) and an overall VRS score of ≥ 2 (31% vs. 16 %, p = 0.04) or ≥ 3 (48% vs. 17%, p = 0.01) at the 1-year proctoscopy. CONCLUSIONS: Early proctoscopy (1 year) predicts late rectal bleeding and therefore can be used as a surrogate endpoint for late rectal toxicity in studies aimed at reducing this frequent complication.
Authors: Robin Krol; Robert Jan Smeenk; Emile N J T van Lin; Eric E K Yeoh; Wim P M Hopman Journal: Int J Colorectal Dis Date: 2013-10-23 Impact factor: 2.571
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Authors: Ricky A Sharma; Ruth Plummer; Julie K Stock; Tessa A Greenhalgh; Ozlem Ataman; Stephen Kelly; Robert Clay; Richard A Adams; Richard D Baird; Lucinda Billingham; Sarah R Brown; Sean Buckland; Helen Bulbeck; Anthony J Chalmers; Glen Clack; Aaron N Cranston; Lars Damstrup; Roberta Ferraldeschi; Martin D Forster; Julian Golec; Russell M Hagan; Emma Hall; Axel-R Hanauske; Kevin J Harrington; Tom Haswell; Maria A Hawkins; Tim Illidge; Hazel Jones; Andrew S Kennedy; Fiona McDonald; Thorsten Melcher; James P B O'Connor; John R Pollard; Mark P Saunders; David Sebag-Montefiore; Melanie Smitt; John Staffurth; Ian J Stratford; Stephen R Wedge Journal: Nat Rev Clin Oncol Date: 2016-06-01 Impact factor: 66.675
Authors: Daniel Y Joh; Leonard N Chen; Gerald Porter; Aditi Bhagat; Sumit Sood; Joy S Kim; Rudy Moures; Thomas Yung; Siyuan Lei; Brian T Collins; Andrew W Ju; Simeng Suy; John Carroll; John H Lynch; Anatoly Dritschilo; Sean P Collins Journal: Radiat Oncol Date: 2014-12-12 Impact factor: 3.481