[Severe (RTOG grades 3 or 4) long-term complications of adjuvant radiotherapy after total prostatectomy].
OBJECTIVE
Study of the incidence of severe long-term gastrointestinal (GI) and genitourinary (GU) complications of conformal radiotherapy after total prostatectomy for localized prostatic adenocarcinoma.


METHODS
From 1991 to 2000, 114 patients with a mean age of 62 years (range: 45-82 years) were treated by total prostatectomy followed by adjuvant radiotherapy. The mean dose of radiotherapy was 65 Gy (range: 58-72 Gy). The mean interval between prostatectomy and radiotherapy was 10 months (range: 2-28 months). Patients were reviewed every 6 months. We studied severe complications (RTOG grade 3 or 4) occurring after treatment. The mean follow-up was 74 months (range: 32-132 months).


RESULTS
Eight patients (7%) treated by adjuvant radiotherapy with a mean dose of 65.5 Gy (range: 59-70 Gy) developed long-term severe complications. The mean time to onset of complications was 25 months (range: 5-72 months). Three patients developed gastrointestinal complications (2 cases of radiation proctitis and 1 anal stricture). Five patients developed genitourinary complications (4 cases of radiation cystitis and 1 urethral stricture). These eight patients received multiple transfusions and required surgical or endoscopic procedures. Most patients were hospitalized on several occasions for periods ranging between 3 days and 1 month.


CONCLUSIONS
Adjuvant radiotherapy after total prostatectomy is associated with severe long-term complications in 7% of cases. When they occur, these complications generally require repeated major urological and gastrointestinal surgery.
Huyghe
Eric
E
Fédération d'Urologie, Hôpital Rangueil, Toulouse, France. huyghe.e@chu-toulouse.fr
Nohra
Joe
J
Khedi
Mehdi
M
Soulié
Michel
M
Rischmann
Pascal
P
Bachaud
Jean-Marc
JM
Plante
Pierre
P
D000368:Aged; D000369:Aged, 80 and over; D001004:Anus Diseases / Q000209:etiology; D003251:Constriction, Pathologic / Q000209:etiology; D003556:Cystitis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011349:Proctitis / Q000209:etiology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D012720:Severity of Illness Index; D013997:Time Factors; D014525:Urethral Stricture / Q000209:etiology