title: Adjuvant androgen deprivation impacts late rectal toxicity after conformal radiotherapy of prostate carcinoma.
abstract: To evaluate whether androgen deprivation impacts late rectal toxicity in patients with localised prostate carcinoma treated with three-dimensional conformal radiotherapy. One hundred and eighty-two consecutive patients treated with 3DCRT between 1995 and 1999 at our Institution and with at least 12 months follow-up were analysed. three-dimensional conformal radiotherapy consisted in 70-76 Gy delivered with a conformal 3-field arrangement to the prostate+/-seminal vesicles. As part of treatment, 117 patients (64%) received neo-adjuvant and concomitant androgen deprivation while 88 (48.4%) patients were continued on androgen deprivation at the end of three-dimensional conformal radiotherapy as well. Late rectal toxicity was graded according to the RTOG morbidity scoring scale. Median follow up is 25.8 (range: 12-70.2 months). The 2-year actuarial likelihood of grade 2-4 rectal toxicity was 21.8+/-3.2%. A multivariate analysis identified the use of adjuvant androgen deprivation (P=0.0196) along with the dose to the posterior wall of the rectum on the central axis (P=0.0055) and the grade of acute rectal toxicity (P=0.0172) as independent predictors of grade 2-4 late rectal toxicity. The 2-year estimates of grade 2-4 late rectal toxicity for patients receiving or not adjuvant hormonal treatment were 30.3+/-5.2% and 14.1+/-3.8%, respectively. Rectal tolerance is reduced in presence of adjuvant androgen deprivation.
authors.affiliation: Department of Radiation Oncology, National Institute for Cancer Research, Genoa, Italy. gisangui@utmb.edu
authors.forename: G
authors.initials: G
authors.lastname: Sanguineti
authors.forename: S
authors.initials: S
authors.lastname: Agostinelli
authors.forename: F
authors.initials: F
authors.lastname: Foppiano
authors.forename: P
authors.initials: P
authors.lastname: Franzone
authors.forename: S
authors.initials: S
authors.lastname: Garelli
authors.forename: M
authors.initials: M
authors.lastname: Marcenaro
authors.forename: M
authors.initials: M
authors.lastname: Orsatti
authors.forename: V
authors.initials: V
authors.lastname: Vitale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000453:epidemiology / Q000473:pathology*; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D012002:Rectal Diseases / Q000209:etiology*; D012007:Rectum / Q000528:radiation effects*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal