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Time course of late rectal toxicity after radiation therapy for prostate cancer

Prostate Cancer and Prostatic Diseases volume 13, pages 138–143 (2010)Cite this article

Abstract

Rectum and bladder are the crucial organs at risk for curative radiation therapy of localized prostate cancer. We analyzed the incidence, profile and time course of late rectal radiation toxicity. A total of 320 patients with T1–3 prostate cancer were treated with three-dimensional conformal radiation therapy (3D-CRT). The prescription dose was 70 Gy for T1 and T2 patients (n=230) and 74 Gy for patients with locally advanced T3 tumors (n=90). Late rectal toxicity was graded according to the Fox Chase modification of the Radiation Therapy Oncology Group (RTOG) and Late Effects Normal Tissue Task Force (LENT) criteria. The median follow-up time was 6.2 years (range 0.2–10.7 years). At 5 years, the risk for the development of grade 2 and 3 rectal toxicities was 15.6 and 7.0%, respectively. All new cases of grade 2 and 3 rectal toxicities were observed within 5 years after treatment. Prevalence of grade 2 and 3 rectal symptoms showed fluctuation with maximum at 1.5 years and the minor peak at 4.5 years. Toxicity profile changed significantly over time. The proportion of rectal bleeding within grade 2 and 3 toxicity decreased from 85% at 1.5 years to 46% at 4.5 years. Conversely, the proportion of fecal incontinence among grade 2 and 3 rectal symptoms gradually increased (0% at 1.5 years vs 27% at 4.5 years). Late rectal radiation toxicity represents a dynamic process. Rectal bleeding decreases and fecal incontinence increases over time.

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Authors and Affiliations

  1. Department of Radiation Oncology, Multiscan and Pardubice Regional Hospital, Pardubice, Czech Republic

    K Odrazka, M Dolezel, J Vanasek & I Kolarova

  2. First and Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

    K Odrazka

  3. Institute for Postgraduate Medical Education, Prague, Czech Republic

    K Odrazka & M Dolezel

  4. Department of Clinical Oncology, Nachod Regional Hospital, Nachod, Czech Republic

    M Vaculikova

  5. Department of Oncology and Radiotherapy, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

    M Zouhar, J Sefrova, P Paluska, M Vosmik & Z Macingova

  6. Department of Nuclear Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

    T Kohlova

  7. Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

    P Navratil & M Brodak

  8. Department of Urology, Nachod Regional Hospital, Nachod, Czech Republic

    P Prosvic

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  1. K Odrazka
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Correspondence to K Odrazka.

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Odrazka, K., Dolezel, M., Vanasek, J. et al. Time course of late rectal toxicity after radiation therapy for prostate cancer. Prostate Cancer Prostatic Dis 13, 138–143 (2010). https://doi.org/10.1038/pcan.2009.56

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  • DOI: https://doi.org/10.1038/pcan.2009.56

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