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In Vivo ; 31(5): 961-966, 2017.
Article in English | MEDLINE | ID: mdl-28882966

ABSTRACT

BACKGROUND/AIM: The Vienna Rectoscopy Score (VRS; from 0, absence of rectal mucosal changes, to 5) assessed 1 year after radiotherapy is a surrogate end-point of late rectal toxicity. The aim of this study was to investigate the association between treatment-related factors and 1-year VRS. PATIENTS AND METHODS: We performed a retrospective analysis of prospectively collected data. Patients with prostate adenocarcinoma treated with definitive or postoperative radiotherapy (RT) underwent endoscopy 1 year after RT. Relationships between VRS of 2 or more and treatment parameters were investigated by univariate and multivariate logistic analyses. RESULTS: One hundred and ninety-five patients (mean age=69 years; range=43-81 years) were considered eligible for the study. At univariate analysis, patients treated with hypofractionation plus radiosurgery boost (p<0.001) and an equivalent dose in 2 Gy per fraction (EQD2) (α/ß=3) ≥75 Gy (p<0.001) was associated with a significantly higher incidence of VRS ≥2 after 1 year of follow-up. At multivariate analysis, radiosurgery boost was an independent risk factor for developing rectal mucosal lesions (VRS ≥2), yielding an odds ratio (OR) of 4.14 (95% confidence interval (CI)=1.2-13.8), while pelvic surgery was inversely associated with VRS ≥2 (OR=0.39; 95% CI=0.17-0.94). CONCLUSION: Hypofractionation followed by radiosurgery boost significantly increased the risk of developing late-onset rectal mucosal changes. Therefore, special care and preventative treatment strategies are needed when using radiosurgery boost after hypofractionated RT.


Subject(s)
Intestinal Mucosa/pathology , Intestinal Mucosa/radiation effects , Prostatic Neoplasms/complications , Radiation Injuries/diagnosis , Radiation Injuries/etiology , Radiotherapy/adverse effects , Rectum/pathology , Rectum/radiation effects , Adult , Aged , Aged, 80 and over , Colonoscopy , Humans , Male , Middle Aged , Prostatic Neoplasms/radiotherapy , Radiotherapy Dosage , Radiotherapy, Conformal/adverse effects , Radiotherapy, Conformal/methods , Radiotherapy, Intensity-Modulated/adverse effects , Radiotherapy, Intensity-Modulated/methods , Retrospective Studies
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