Statins Protect Against Acute RT-related Rectal Toxicity in Patients with Prostate Cancer: An Observational Prospective Study.
To analyze risk factors for acute rectal toxicity during hypofractionated intensity-modulated radiotherapy (IMRT) for prostate cancer.



A total of 195 patients received 74.25 Gy in 33 fractions to the prostate and, if involved, to the seminal vescicles (SV). When the risk of SV involvement was >15% according to the Roach's formula, they received 62 Gy in 33 fractions. Overall, 107/195 patients (54.87%) received hormonal therapy (luteinizing hormone-releasing hormone analogue, anti-androgen, or both). Common Terminology Criteria for Adverse Events version 3.0 was used to classify rectal toxicity.



Acute rectal toxicity occurred in 79 (40.51%) patients (grade 1 in 44). In univariate analysis, use of calcium channel blockers significantly reduced the acute rectal toxicity rate and 3-hydroxy-methylglutaryl CoA reductase inhibitors (statins) significantly reduced the rectal toxicity rate and grade. In multivariate analysis, only statin use was an independent protective factor.



In patients with prostate cancer treated with a moderate hypofractionated IMRT schedule, use of statins lowered the incidence and grade of acute rectal toxicity.
Radiation Oncology Section, University of Perugia, Perugia, Italy isabella.palumbo@unipg.it.|Radiation Oncology Division, Perugia General Hospital, Perugia, Italy.
Isabella
I
Palumbo
Radiation Oncology Section, University of Perugia, Perugia, Italy.
Fabio
F
Matrone
Radiation Oncology Section, University of Perugia, Perugia, Italy.
Giampaolo
G
Montesi
Radiation Oncology Division, Perugia General Hospital, Perugia, Italy.
Rita
R
Bellavita
Radiation Oncology Division, Perugia General Hospital, Perugia, Italy.
Marco
M
Lupattelli
Radiation Oncology Section, University of Perugia, Perugia, Italy.
Simonetta
S
Saldi
Radiation Oncology Division, Perugia General Hospital, Perugia, Italy.
Alessandro
A
Frattegiani
Radiation Oncology Section, University of Perugia, Perugia, Italy.
Eleonora
E
Arena
Radiation Oncology Section, University of Perugia, Perugia, Italy.
Cristina
C
Mariucci
Radiation Oncology Division, Perugia General Hospital, Perugia, Italy.
Lorenzo
L
Falcinelli
Internal Medicine, Endocrine and Metabolic Science Section, University of Perugia, Perugia, Italy.
Vittorio
V
Bini
Radiation Oncology Section, University of Perugia, Perugia, Italy.|Radiation Oncology Division, Perugia General Hospital, Perugia, Italy.
Cynthia
C
Aristei
D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control*; D011874:Radiometry; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012007:Rectum / Q000528:radiation effects*; D012307:Risk Factors; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017430:Prostate-Specific Antigen
Prostate cancer; acute rectal toxicity; hypofractionation; intensity-modulated radiotherapy; statins