Severe rectal injury following radiation for prostatic cancer.
Between 1970 and 1981, 348 patients underwent definitive irradiation. Of these patients 6 (1.7 per cent) sustained severe rectal injury as manifest by major rectal bleeding, rectal stricture, rectal mucosal slough and rectal ulceration. Severe rectal injury was observed in 0 of 13 patients (0 per cent) treated with 125iodine, 3 of 329 (1 per cent) treated with 6,400 to 6,800 rad external irradiation, 2 of 39 (5 per cent) treated with 7,000 to 7,300 rad external irradiation, and 1 of 7 (14 per cent) treated with 198gold and external irradiation. The impact of radiation dose, radiation therapy technique and surgical trauma was assessed. Rectal injury was managed by supportive measures in 2 patients and by diverting colostomy in 3 with benefit. One patient underwent abdominoperineal resection. A small bowel fistula and an intra-abdominal abscess developed, and the patient died.
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D006050:Gold Radioisotopes / Q000009:adverse effects; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects*; D012002:Rectal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D006050:Gold Radioisotopes; D007457:Iodine Radioisotopes