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Rep Pract Oncol Radiother. 2013 Jun 21;18(5):298-303. doi: 10.1016/j.rpor.2013.05.006. eCollection 2013.

Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results.

Author information

1
Catalan Institute of Oncology. Hospital Universitari "Josep Trueta" Girona, Spain ; Institut de Recerca Biomèdica de Girona, IDIBGi, Spain.
2
Unit of Hyperbaric Medicine, Hospital de Palamós, Girona, Spain.

Abstract

AIM:

This study aimed at investigating factors associated to late rectal and bladder toxicity following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2.

BACKGROUND:

Radiation is frequently used for prostate cancer, but a 5-20% incidence of late radiation proctitis and cystitis exists. Some clinical and dosimetric factors have been defined without a full agreement. For patients diagnosed of late chronic proctitis and/or cystitis grade ≥2 treatment is not well defined. Hyperbaric Oxygen Therapy (HBOT) has been used, but its effectiveness is not well known.

MATERIALS AND METHODS:

257 patients were treated with radiation therapy for prostate cancer. Clinical, pharmacological and dosimetric parameters were collected. Patients having a grade ≥2 toxicity were treated with HBOT. Results of the intervention were measured by monitoring toxicity by Common Toxicity Criteria v3 (CTCv3).

RESULTS:

Late rectal toxicity was related to the volume irradiated, i.e. V50 > 53.64 (p = 0.013); V60 > 38.59% (p = 0.005); V65 > 31.09% (p = 0.002) and V70 > 22.81% (p = 0.012). We could not correlate the volume for bladder. A total of 24 (9.3%) patients experienced a grade ≥2. Only the use of dicumarinic treatment was significant for late rectal toxicity (p = 0.014). A total of 14 patients needed HBOT. Final percentage of patients with a persistent toxicity grade ≥2 was 4.5%.

CONCLUSION:

Rectal volume irradiated and dicumarinic treatment were associated to late rectal/bladder toxicity. When toxicity grade ≥2 is diagnosed, HBOT significantly ameliorate symptoms.

KEYWORDS:

Bladder toxicity; Hyperbaric oxygen; Predictive factors; Radiotherapy; Rectal toxicity; Treatment

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