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Rep Pract Oncol Radiother. 2017 Jan-Feb;22(1):77-82. Epub 2016 Nov 25.

Long term clinical toxicity of radiation therapy in prostate cancer patients with Inflammatory Bowel Disease.

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1
Department of Radiation Oncology, Scott and White Memorial Hospital, Texas A&M University School of Medicine, Temple, TX 76508, USA.

Abstract

AIM:

The study's aim was to examine the clinical impact of radiation therapy (RT) on GI toxicity in Inflammatory Bowel Disease (IBD) patients.

BACKGROUND:

IBD has long been considered a risk factor for increased bowel toxicity from RT; however, minimal evidence exists on patients with prostate cancer (PC) and IBD.

MATERIALS AND METHODS:

The tumor registry was queried for patients with IBD and PC from the years 1990-2013. A retrospective review was conducted for patients who received RT. Radiation treatment and toxicity data were collected.

RESULTS:

Average length of follow-up was 12 years (median 9.54, range 0.42-19.9). The majority had well controlled baseline bowel function on medical management. Prior to radiation, 60% of patients (9/15) and 40% (6/15) reported grade 0 (G0) and grade (G1) diarrhea at baseline, respectively. No baseline proctitis existed. Following radiation treatment, 78% (14/18) of patients experienced G0 diarrhea while 22% (4/18) reported G1 diarrhea. No patients suffered from greater than G1 diarrhea. Sixty-six percent (12/18), 17% (3/18) and 17% (3/18) of patients experienced G0, G1, and G2 proctitis, respectively. No patients suffered post-radiation stricture formation, and all patients with G2 proctitis received 3dCRT.

CONCLUSIONS:

Limited published data is available exploring RT for patients with PC and IBD. This analysis offers valuable insight into appropriate counseling for a rare patient subset. Radiation improved late G1 diarrhea rates. Grade 2 proctitis was only encountered in 3dCRT patients. No post-radiation complications occurred. Our findings suggest that IBD patients experience minimal toxicity in the era of IMRT based RT.

KEYWORDS:

Inflammatory Bowel Disease, IBD; Radiation induced bowel toxicity; Radiation proctitis

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