Georgios Kounadis1, Nikolaos Syrigos1, Andromachi Kougioumtzopoulou2, Georgios Bamias3, Ilias Kotteas1, Georgios Papatheodoridis4, Dimitra Grapsa5. 1. Oncology Unit, 3 Department of Internal Medicine, Sotiria Athens General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 2. Radiotherapy Unit, 2 Department of Radiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 3. Department of Gastroenterology, 3 Department of Internal Medicine, Sotiria Athens General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 4. Department of Gastroenterology, Laiko Athens General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 5. Oncology Unit, 3 Department of Internal Medicine, Sotiria Athens General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; dimgrap@yahoo.gr.
Abstract
BACKGROUND/AIM: Previous randomized clinical trials have shown that moderate hypofractionation has a non-inferior or even superior efficacy to conventionally fractionated external beam radiation therapy (EBRT) in low and intermediate-risk prostate cancer. We herein aimed to evaluate the acute and late gastrointestinal (GI) toxicity of hypofractionated radiotherapy (HRT) in a real-world setting. PATIENTS AND METHODS: Patients with intermediate-risk prostate adenocarcinoma eligible to receive HRT were prospectively enrolled. All patients were submitted to rectoscopy after completion of HRT, every three months after radiotherapy for the first year and every six months for the second year. Toxicity events were classified as acute, when presenting during radiotherapy or within the first three months following its completion, and as late when appearing three months to three years post-HRT. RESULTS: Twenty prostate cancer patients participated in this study and received 22 sessions of HRT (5 sessions a week; 2.75 Gy per session) and an overall dose of 60.5 Gy. None of our patients developed acute GI toxicity; late GI toxicity (RTOG/EORTC grade 3 rectal bleeding) was observed in 1 patient only (1/20, 5%), at 6- and 12-months post-HRT. No rectal mucosa damage was observed on follow-up rectoscopy in the acute phase in any of our patients; five patients (5/20, 25%) developed late telangiectasias. Vienna retroscopy score (VRS) was 1 in 4/5 patients (80%) and 2 in 1/5 (20%). CONCLUSION: Minimal radiation-induced rectal mucosal damage was observed in our patient population, and only as a late event, further attesting to the safety of HRT in this setting.
BACKGROUND/AIM: Previous randomized clinical trials have shown that moderate hypofractionation has a non-inferior or even superior efficacy to conventionally fractionated external beam radiation therapy (EBRT) in low and intermediate-risk prostate cancer. We herein aimed to evaluate the acute and late gastrointestinal (GI) toxicity of hypofractionated radiotherapy (HRT) in a real-world setting. PATIENTS AND METHODS: Patients with intermediate-risk prostate adenocarcinoma eligible to receive HRT were prospectively enrolled. All patients were submitted to rectoscopy after completion of HRT, every three months after radiotherapy for the first year and every six months for the second year. Toxicity events were classified as acute, when presenting during radiotherapy or within the first three months following its completion, and as late when appearing three months to three years post-HRT. RESULTS: Twenty prostate cancer patients participated in this study and received 22 sessions of HRT (5 sessions a week; 2.75 Gy per session) and an overall dose of 60.5 Gy. None of our patients developed acute GI toxicity; late GI toxicity (RTOG/EORTC grade 3 rectal bleeding) was observed in 1 patient only (1/20, 5%), at 6- and 12-months post-HRT. No rectal mucosa damage was observed on follow-up rectoscopy in the acute phase in any of our patients; five patients (5/20, 25%) developed late telangiectasias. Vienna retroscopy score (VRS) was 1 in 4/5 patients (80%) and 2 in 1/5 (20%). CONCLUSION: Minimal radiation-induced rectal mucosal damage was observed in our patient population, and only as a late event, further attesting to the safety of HRT in this setting.
Authors: Gregor Goldner; Birgit Tomicek; Gerd Becker; Hans Geinitz; Stefan Wachter; Frank Zimmermann; Natascha Wachter-Gerstner; Jochen Reibenwein; Stefan Glocker; Michael Bamberg; Horst Feldmann; Regina Pötzi; Michael Molls; Richard Pötter Journal: Int J Radiat Oncol Biol Phys Date: 2007-01-01 Impact factor: 7.038
Authors: David J Brenner; Alvaro A Martinez; Gregory K Edmundson; Christina Mitchell; Howard D Thames; Elwood P Armour Journal: Int J Radiat Oncol Biol Phys Date: 2002-01-01 Impact factor: 7.038
Authors: Alan Pollack; Gail Walker; Eric M Horwitz; Robert Price; Steven Feigenberg; Andre A Konski; Radka Stoyanova; Benjamin Movsas; Richard E Greenberg; Robert G Uzzo; Charlie Ma; Mark K Buyyounouski Journal: J Clin Oncol Date: 2013-10-07 Impact factor: 44.544