3-D conformal radiotherapy of localized prostate cancer: a subgroup analysis of rectoscopic findings prior to radiotherapy and acute/late rectal side effects.
OBJECTIVE
To identify endoscopic pathological findings prior to radiotherapy and a possible correlation with acute or chronic rectal side effects after three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer.


METHODS
Between 03/99 and 07/02, a total of 298 patients, who consented in a voluntary rectoscopy prior to radiotherapy were included into the analysis. Patients were treated with a total dose of either 70 or 74 Gy. Pathological rectoscopic findings like hemorrhoids, polyps or diverticula were documented. Acute and late rectal side effects were scored using the EORTC/RTOG score.


RESULTS
The most frequent pathological endosopic findings were hemorrhoids (35%), polyps (24%) and diverticula (13%). Rectal toxicity was mostly low to moderate. Grade 0/1 cumulative acute and late rectal side effects were 82 and 84%, grade 2 were 18 and 17%, respectively. We could not identify any correlation between preexisting pathological findings and rectal side effects by statistical analysis.


CONCLUSIONS
There is no evidence that prostate cancer patients presenting with endoscopic verified pathological findings in the rectal mucosa at diagnosis are at an increased risk to develop rectal side effects when treated with 3D-CRT of the prostatic region.
Goldner
Gregor
G
Department of Radiotherapy and Radiobiology, Vienna General Hospital, University of Vienna Medical School,Vienna, Austria. gregor.goldner@akhwien.at
Zimmermann
Frank
F
Feldmann
Horst
H
Glocker
Stefan
S
Wachter-Gerstner
Natascha
N
Geinitz
Hans
H
Becker
Gerd
G
Pötzi
Regina
R
Wambersie
Andre
A
Bamberg
Michael
M
Molls
Michael
M
Wachter
Stefan
S
Pötter
Richard
R
D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D004240:Diverticulum / Q000150:complications / Q000175:diagnosis; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000150:complications / Q000175:diagnosis; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D012007:Rectum / Q000098:blood supply / Q000473:pathology* / Q000528:radiation effects