title: Patient-reported gastrointestinal symptoms among long-term survivors after radiation therapy for prostate cancer.
abstract: OBJECTIVE
  With modern radiotherapy technology we have the means to substantially reduce late gastrointestinal toxicities after radiation therapy for prostate cancer. However, there is still a lack of knowledge regarding the spectrum of patient-reported gastrointestinal symptoms after such treatment.
  
  
  METHODS
  We conducted a cross-sectional study using a study-specific questionnaire to survey gastrointestinal symptoms 2-14years after prostate cancer radiation therapy. We included 985 men treated between 1994 and 2006 with primary (EBRT) or salvage (POSTOP) external beam radiation therapy or EBRT and high-dose rate brachytherapy (EBRT BT). We also included 350 non-irradiated population-based controls randomly matched 1:3 for age and area of residence.
  
  
  RESULTS
  Survey participation rate was 89% (874/985) for survivors and 73% (243/332) for controls. We found significant increased prevalence ratios for 13/34 symptoms in the primary EBRT group, 10/34 symptoms in the EBRT BT group and 9/34 symptoms in the POSTOP group, several of which have not been described previously. Bother due to these symptoms increased with increasing symptom intensity and was highest for fecal leakage and defecation urgency.
  
  
  CONCLUSIONS
  Our results can be used to inform clinical evaluation and future studies of long-term gastrointestinal toxicity after radiotherapy for prostate cancer.
authors.affiliation: Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. Electronic address: david.alsadius@oncology.gu.se.
authors.forename: David
authors.initials: D
authors.lastname: Alsadius
authors.affiliation: Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.
authors.forename: Caroline
authors.initials: C
authors.lastname: Olsson
authors.affiliation: Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Niclas
authors.initials: N
authors.lastname: Pettersson
authors.affiliation: Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Tucker
authors.affiliation: Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.
authors.forename: Ulrica
authors.initials: U
authors.lastname: Wilderäng
authors.affiliation: Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden; Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology* / Q000503:physiopathology*; D016879:Salvage Therapy; D011795:Surveys and Questionnaires; D017741:Survivors
keywords: Gastrointestinal; Late toxicity; Patient-reported outcomes; Prostate cancer; Radiation therapy