title: Healing of late endoscopic changes in the rectum between 12 and 65 months after external beam radiotherapy.
abstract: OBJECTIVE
  To evaluate the time course of late rectal mucosal changes after prostate cancer radiotherapy (RT).
  
  
  METHODS
  A rectosigmoidoscopy was performed at 12, 24, and 65 months after RT in 20 patients. Rectal mucosal changes (telangiectasia, congested mucosa, ulceration, stricture, and necrosis) were scored and documented according to the Vienna Rectoscopy Score (VRS, score 0-3).
  
  
  RESULTS
  VRS of 0 and 3, were found in 20% of patients (n = 4) and 5% of patients (n = 1), respectively at all time points. A shift of the VRS from 2 to 1 was found with incidence rates of 60% at 12 months and 20% at 65 months, which is equivalent to an improvement rate of 67%. Laser coagulation was required in 3 patients (15%) with rectal bleeding due to telangiectasia grade ≥2.
  
  
  CONCLUSIONS
  Late rectal mucosal changes are frequent after pelvic RT. Generally only the incidence rates corresponding to the initial diagnosis of the complications, independent of subsequent recovery, are reported. The results reported in the present study show that complications often improve over time. Hence, the usual reports of complication rates overestimate the proportion of patients presenting with side effects of certain grades.
authors.affiliation: Department of Radiotherapy and Radiobiology, Vienna General Hospital, University of Vienna Medical School, Austria. Gregor.Goldner@akhwien.at
authors.forename: Gregor
authors.initials: G
authors.lastname: Goldner
authors.forename: Richard
authors.initials: R
authors.lastname: Pötter
authors.forename: Alexander
authors.initials: A
authors.lastname: Kranz
authors.forename: Alexandra
authors.initials: A
authors.lastname: Bluhm
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dörr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004487:Edema / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology* / Q000528:radiation effects*; D007415:Intestinal Obstruction / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011349:Proctitis / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000473:pathology*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D012002:Rectal Diseases / Q000473:pathology; D012007:Rectum / Q000473:pathology* / Q000528:radiation effects*; D012812:Sigmoidoscopy; D013684:Telangiectasis / Q000473:pathology; D014456:Ulcer / Q000473:pathology; D014945:Wound Healing / Q000528:radiation effects*