title: Radioprotective effect of calcium channel blockers against late rectal bleeding in prostate cancer.
abstract: OBJECTIVE
  This study was done to assess the impact of clinical factors and in particular the use of drugs for concomitant illnesses on late radiation-induced rectal bleeding in patients with prostate cancer.
  
  
  METHODS
  Patients with histologically proven prostate adenocarcinoma treated with radical radiotherapy and followed up for at least 6 months were selected. The correlation between late rectal bleeding and a number of factors was investigated by univariate and multivariate analysis.
  
  
  RESULTS
  A total of 278 patients who underwent radiotherapy at our institution between October 2002 and May 2011 were selected. At univariate analysis, delivery of radiation doses higher than 70 Gy and use of angiotensin-converting enzyme inhibitors were associated with a higher incidence of rectal bleeding. Conversely, patients who used calcium channel blockers had a lower risk (3-year rectal bleeding-free survival 89.8 versus 66.5 %, p = 0.043). At multivariate analysis, use of calcium channel blockers was found to have a protective effect with a hazard ratio of 0.3 (95 % CI 0.12-0.96). Delivery of higher radiation doses was associated with an increased risk of rectal bleeding (hazard ratio 3.02, 95 % CI 1.23-7.38).
  
  
  CONCLUSIONS
  Use of calcium channel blockers during and after radiotherapy treatment might have a protective effect against late rectal bleeding. If these results are reconfirmed by larger clinical series, calcium channel blockers may be tested as radioprotector agents in clinical trials.
authors: Department of Radiation Oncology, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del S. Cuore, Largo A. Gemelli 1, 86100, Campobasso, Italy.
authors: Mariangela
authors: M
authors: Massaccesi
authors: Edy
authors: E
authors: Ippolito
authors: Francesco
authors: F
authors: Deodato
authors: Savino
authors: S
authors: Cilla
authors: Cinzia
authors: C
authors: Digesù
authors: Gabriella
authors: G
authors: Macchia
authors: Luciana
authors: L
authors: Caravatta
authors: Vincenzo
authors: V
authors: Picardi
authors: Gian Carlo
authors: GC
authors: Mattiucci
authors: Alessandra
authors: A
authors: Di Lallo
authors: Daniele
authors: D
authors: Cuscunà
authors: Numa
authors: N
authors: Cellini
authors: Vincenzo
authors: V
authors: Valentini
authors: Alessio G
authors: AG
authors: Morganti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology* / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D012007:Rectum / Q000187:drug effects* / Q000528:radiation effects*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers