Robin Krol1, Gill M McColl2, Wim P M Hopman3, Robert J Smeenk2. 1. Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: robin.krol@radboudumc.nl. 2. Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. 3. Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Abstract
BACKGROUND AND PURPOSE: Late anorectal toxicity influences quality of life after external beam radiotherapy (EBRT) for prostate cancer. A daily inserted endorectal balloon (ERB) during EBRT aims to reduce anorectal toxicity. Our goal is to objectify anorectal function over time after prostate intensity-modulated radiotherapy (IMRT) with ERB. MATERIAL AND METHODS: Sixty men, irradiated with IMRT and an ERB, underwent barostat measurements and anorectal manometry prior to EBRT and 6 months, one year and 2 years after radiotherapy. Primary outcome measures were rectal distensibility and rectal sensibility in response to stepwise isobaric distensions and anal pressures. RESULTS: Forty-eight men completed all measurements. EBRT reduced maximal rectal capacity 2 years after EBRT (250 ± 10 mL vs. 211 ± 10 mL; p < 0.001), area under the pressure-volume curve (2878 ± 270 mL mmHg vs. 2521 ± 305 mL mmHg; p = 0.043) and rectal compliance (NS). Sensory pressure thresholds for first sense and first urge (both p < 0.01) increased. Anal maximum pressure diminished after IMRT (p = 0.006). CONCLUSIONS: Rectal capacity and sensory function are increasingly affected over time after radiotherapy. There is an indication that these reductions are affected less with IMRT + ERB compared to conventional radiation techniques.
BACKGROUND AND PURPOSE: Late anorectal toxicity influences quality of life after external beam radiotherapy (EBRT) for prostate cancer. A daily inserted endorectal balloon (ERB) during EBRT aims to reduce anorectal toxicity. Our goal is to objectify anorectal function over time after prostate intensity-modulated radiotherapy (IMRT) with ERB. MATERIAL AND METHODS: Sixty men, irradiated with IMRT and an ERB, underwent barostat measurements and anorectal manometry prior to EBRT and 6 months, one year and 2 years after radiotherapy. Primary outcome measures were rectal distensibility and rectal sensibility in response to stepwise isobaric distensions and anal pressures. RESULTS: Forty-eight men completed all measurements. EBRT reduced maximal rectal capacity 2 years after EBRT (250 ± 10 mL vs. 211 ± 10 mL; p < 0.001), area under the pressure-volume curve (2878 ± 270 mL mmHg vs. 2521 ± 305 mL mmHg; p = 0.043) and rectal compliance (NS). Sensory pressure thresholds for first sense and first urge (both p < 0.01) increased. Anal maximum pressure diminished after IMRT (p = 0.006). CONCLUSIONS: Rectal capacity and sensory function are increasingly affected over time after radiotherapy. There is an indication that these reductions are affected less with IMRT + ERB compared to conventional radiation techniques.
Authors: Marigdalia K Ramirez-Fort; Marc J Rogers; Roberto Santiago; Sean S Mahase; Melissa Mendez; Yi Zheng; Xiang Kong; James A Kashanian; M Junaid Niaz; Shearwood McClelland; Xiaodong Wu; Neil H Bander; Peter Schlegel; John P Mulhall; Christopher S Lange Journal: Rep Pract Oncol Radiother Date: 2020-03-19
Authors: Thomas Zilli; Sandra Jorcano; Samuel Bral; Carmen Rubio; Anna M E Bruynzeel; Angelo Oliveira; Ufuk Abacioglu; Heikki Minn; Zvi Symon; Raymond Miralbell Journal: Cancer Med Date: 2020-03-11 Impact factor: 4.452