The Vienna Rectoscopy Score (VRS; from 0, absence of rectal mucosal changes, to 5) assessed 1 year after radiotherapy is a surrogate end-point of late rectal toxicity. The aim of this study was to investigate the association between treatment-related factors and 1-year VRS. PATIENTS AND METHODS: We performed a retrospective analysis of prospectively collected data. Patients with prostate adenocarcinoma treated with definitive or postoperative radiotherapy (RT) underwent endoscopy 1 year after RT. Relationships between VRS of 2 or more and treatment parameters were investigated by univariate and multivariate logistic analyses. RESULTS: One hundred and ninety-five patients (mean age=69 years; range=43-81 years) were considered eligible for the study. At univariate analysis, patients treated with hypofractionation plus radiosurgery boost (p<0.001) and an equivalent dose in 2 Gy per fraction (EQD2) (α/β=3) ≥75 Gy (p<0.001) was associated with a significantly higher incidence of VRS ≥2 after 1 year of follow-up. At multivariate analysis, radiosurgery boost was an independent risk factor for developing rectal mucosal lesions (VRS ≥2), yielding an odds ratio (OR) of 4.14 (95% confidence interval (CI)=1.2-13.8), while pelvic surgery was inversely associated with VRS ≥2 (OR=0.39; 95% CI=0.17-0.94). CONCLUSION: Hypofractionation followed by radiosurgery boost significantly increased the risk of developing late-onset rectal mucosal changes. Therefore, special care and preventative treatment strategies are needed when using radiosurgery boost after hypofractionated RT.

Ippolito, E., Guido, A., Macchia, G., Deodato, F., Giaccherini, L., Farioli, A., Arcelli, A., Cuicchi, D., Frazzoni, L., Cilla, S., Buwenge, M., Mantini, G., Alitto, A. R., Nuzzo, M., Valentini, V., Ingrosso, M., Morganti, A. G., Fuccio, L., Predictive Factors of Late-onset Rectal Mucosal Changes After Radiotherapy of Prostate Cancer, <<IN VIVO>>, 2017; 31 (5): 961-966 [http://hdl.handle.net/10807/111820]

Predictive Factors of Late-onset Rectal Mucosal Changes After Radiotherapy of Prostate Cancer

Ippolito, Edy;Macchia, Gabriella;Deodato, Francesco;Cilla, Savino;Mantini, Giovanna;Alitto, Anna R;Valentini, Vincenzo;Ingrosso, Marcello;Morganti, Alessio G;
2017

Abstract

The Vienna Rectoscopy Score (VRS; from 0, absence of rectal mucosal changes, to 5) assessed 1 year after radiotherapy is a surrogate end-point of late rectal toxicity. The aim of this study was to investigate the association between treatment-related factors and 1-year VRS. PATIENTS AND METHODS: We performed a retrospective analysis of prospectively collected data. Patients with prostate adenocarcinoma treated with definitive or postoperative radiotherapy (RT) underwent endoscopy 1 year after RT. Relationships between VRS of 2 or more and treatment parameters were investigated by univariate and multivariate logistic analyses. RESULTS: One hundred and ninety-five patients (mean age=69 years; range=43-81 years) were considered eligible for the study. At univariate analysis, patients treated with hypofractionation plus radiosurgery boost (p<0.001) and an equivalent dose in 2 Gy per fraction (EQD2) (α/β=3) ≥75 Gy (p<0.001) was associated with a significantly higher incidence of VRS ≥2 after 1 year of follow-up. At multivariate analysis, radiosurgery boost was an independent risk factor for developing rectal mucosal lesions (VRS ≥2), yielding an odds ratio (OR) of 4.14 (95% confidence interval (CI)=1.2-13.8), while pelvic surgery was inversely associated with VRS ≥2 (OR=0.39; 95% CI=0.17-0.94). CONCLUSION: Hypofractionation followed by radiosurgery boost significantly increased the risk of developing late-onset rectal mucosal changes. Therefore, special care and preventative treatment strategies are needed when using radiosurgery boost after hypofractionated RT.
Inglese
Ippolito, E., Guido, A., Macchia, G., Deodato, F., Giaccherini, L., Farioli, A., Arcelli, A., Cuicchi, D., Frazzoni, L., Cilla, S., Buwenge, M., Mantini, G., Alitto, A. R., Nuzzo, M., Valentini, V., Ingrosso, M., Morganti, A. G., Fuccio, L., Predictive Factors of Late-onset Rectal Mucosal Changes After Radiotherapy of Prostate Cancer, <>, 2017; 31 (5): 961-966 [http://hdl.handle.net/10807/111820]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/111820
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 5
social impact