Reporting late rectal toxicity in prostate cancer patients treated with curative radiation treatment.
OBJECTIVE
Long-term rectal toxicity is a concern for patients with prostate cancer treated with curative radiation. However, comparing results of late toxicity may not be straightforward. This article reviews the complexity of reporting long-term side effects by using data for patients treated in our institution with hypofractionated irradiation.


METHODS
Seventy-two patients with localized prostate cancer treated with hypofractionated radiotherapy alone to a dose of 66 Gy in 22 fractions were prospectively assessed for late rectal toxicity according to the Common Toxicity Criteria, Version 3, scoring system. Ninety percent of patients had more than 24 months of follow-up. Results are compared with data published in the literature.


RESULTS
We found an actuarial incidence of Grade 2 or higher late rectal toxicity of 27% at 30 months and a crude incidence of Grade 2 or higher late rectal toxicity of 18%. This was mostly severe toxicity documented during follow-up. The incidence of Grade 3 rectal toxicity at the last visit was 3% compared with 13% documented at any time during follow-up.


CONCLUSIONS
Comparison of late toxicity after radiotherapy in patients with prostate cancer must be undertaken with caution because many factors need to be taken into consideration. Because accurate assessment of late toxicity in the evaluation of long-term outcome after radiotherapy in patients with localized prostate cancer is essential, there is a need to develop by consensus guidelines for assessing and reporting late toxicity in this group of patients.
Faria
Sergio L
SL
Department of Radiation Oncology, McGill University Health Centre, Montreal, Canada.
Souhami
Luis
L
Joshua
Bosede
B
Vuong
Te
T
Freeman
Carolyn R
CR
D000368:Aged; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000000981:diagnostic imaging; D008875:Middle Aged; D017785:Photons / Q000009:adverse effects / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011877:Radionuclide Imaging; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012002:Rectal Diseases / Q000000981:diagnostic imaging*; D013997:Time Factors