Late Rectal Toxicity from Image-guided Intensity Modulated Radiotherapy for Prostate Cancer

Anticancer Res. 2016 Jun;36(6):2967-73.

Abstract

Aim: Late rectal toxicity (LRT) was retrospectively evaluated in men with prostate cancer treated with image-guided intensity modulated radiotherapy (IG-IMRT).

Patients and methods: Between May 2008 and December 2009, 47 men with prostate adenocarcinoma were treated with IG-IMRT using in-room computed tomography (CT).

Results: The median time to grade 2 LRT was 12 months (range=1-24 months). Two of 3 men who developed grade 2 LRT had received treatment for diabetes, and the other was receiving anticoagulant/antiplatelet therapy (AC therapy). Their rectal wall V70 (the volume of rectal wall receiving 70 Gy) values were 12.6%, 13.0%, and 13.3%. Univariate analysis revealed that V70 of the rectal wall was the only significant risk factor for LRT (p=0.0073).

Conclusion: No man with V70 ≤12.0% experienced grade 2 LRT. Strict rectal wall V70 ≤12% dose constraints should be considered when treating prostate cancer patients who are also receiving diabetic or AC therapy.

Keywords: IGRT; IMRT; Prostate cancer; late rectal bleeding.

MeSH terms

  • Adenocarcinoma / radiotherapy*
  • Aged
  • Aged, 80 and over
  • Humans
  • Male
  • Middle Aged
  • Prostatic Neoplasms / radiotherapy*
  • Radiotherapy, Image-Guided*
  • Radiotherapy, Intensity-Modulated / adverse effects*
  • Rectum / radiation effects*
  • Retrospective Studies
  • Tomography, X-Ray Computed