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Radiother Oncol. 2007 Aug;84(2):156-63. Epub 2007 Aug 10.

Late radiotherapy-induced lower intestinal toxicity (RILIT) of intensity-modulated radiotherapy for prostate cancer: the need for adapting toxicity scales and the appearance of the sigmoid colon as co-responsible organ for lower intestinal toxicity.

Author information

1
Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium. fonteynevalerie@hotmail.com

Abstract

PURPOSE:

To report on: 1. Late radiotherapy-induced lower intestinal toxicity (RILIT) after intensity-modulated radiotherapy (IMRT) for prostate cancer. 2. The correlation between late RILIT and volume parameters of the rectum, sigmoid colon and small bowel.

MATERIALS AND METHODS:

We included 241 patients with a follow-up of >or=18 months for this analysis. Late RILIT consisted of 8 different symptoms, comprising the 5 symptoms from the RTOG toxicity score supplemented with urgency, fecal incontinence and anal pain. Late RILIT and late RTOG toxicity were scored prospectively and correlated with: 1. Different rectum, sigmoid colon and small bowel volume parameters. 2. Patient-related morbidity. We calculated the median, quartile and percentiles for the different volume parameters and correlated them with grade 1-3 late RILIT.

RESULTS:

Median follow-up was 42 months. Three patients developed grade 3 red blood loss. We registered grade 2 RILIT and RTOG toxicity in 13% and 10%, respectively, the most frequent grade 1 symptom being fecal urgency. The intermediate rectal volume parameters were significantly correlated with late RILIT. We were able to calculate cut-off dose-volume histograms (DVHs) that predict for grade 0-2 RILIT.

CONCLUSIONS:

After IMRT for prostate cancer, the overall incidence of grade >or=2 RILIT is low. Cut-off DVHs can be used for patient counseling.

PMID:
17692976
DOI:
10.1016/j.radonc.2007.06.013
[Indexed for MEDLINE]

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