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Eur Urol. 2011 Nov;60(5):908-16. doi: 10.1016/j.eururo.2011.05.052. Epub 2011 Jun 12.

Late gastrointestinal toxicities following radiation therapy for prostate cancer.

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  • 1The Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA.

Abstract

BACKGROUND:

Radiation therapy is commonly used to treat localized prostate cancer; however, representative data regarding treatment-related toxicities compared with conservative management are sparse.

OBJECTIVE:

To evaluate gastrointestinal (GI) toxicities in men treated with either primary radiation or conservative management for T1-T2 prostate cancer.

DESIGN, SETTING, AND PARTICIPANTS:

We performed a population-based cohort study, using Medicare claims data linked to the Surveillance Epidemiology and End Results data. Competing risk models were used to evaluate the risks.

MEASUREMENTS:

GI toxicities requiring interventional procedures occurring at least 6 mo after cancer diagnosis.

RESULTS AND LIMITATIONS:

Among 41,737 patients in this study, 28,088 patients received radiation therapy. The most common GI toxicity was GI bleeding or ulceration. GI toxicity rates were 9.3 per 1000 person-years after three-dimensional conformal radiotherapy, 8.9 per 1000 person-years after intensity-modulated radiotherapy, 5.3 per 1000 person-years after brachytherapy alone, 20.1 per 1000 person-years after proton therapy, and 2.1 per 1000 person-years for conservative management patients. Radiation therapy is the most significant factor associated with an increased risk of GI toxicities (hazard ratio [HR]: 4.74; 95% confidence interval [CI], 3.97-5.66). Even after 5 yr, the radiation group continued to experience significantly higher rates of new GI toxicities than the conservative management group (HR: 3.01; 95% CI, 2.06-4.39). Because our cohort of patients were between 66 and 85 yr of age, these results may not be applicable to younger patients.

CONCLUSIONS:

Patients treated with radiation therapy are more likely to have procedural interventions for GI toxicities than patients with conservative management, and the elevated risk persists beyond 5 yr.

Published by Elsevier B.V.

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PMID:
21684064
[PubMed - indexed for MEDLINE]
PMCID:
PMC3185133
Free PMC Article
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