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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Clinical and dosimetric predictors of late rectal toxicity after conformal radiation for localized prostate cancer: results of a large multicenter observational study.
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Clinical and dosimetric predictors of late rectal toxicity after conformal radiation for localized prostate cancer: results of a large multicenter observational study.

机译：局部前列腺癌保形放射后直肠晚期毒性的临床和剂量预测指标：一项大型多中心观察性研究的结果。

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PURPOSE: Assessing the predictors of late rectal toxicity after high-dose conformal radiotherapy for prostate cancer. METHODS: One thousand one hundred thirty-two patients entered a prospective observational multicentric study; late rectal toxicity was evaluated by a self-reported questionnaire. Results concerning bleeding and faecal incontinence of 718/1132 patients with a complete follow-up at 36 months were analysed. The correlation between a number of clinical-dosimetric parameters and moderate/severe toxicity was investigated by univariate and multivariate logistic analyses. RESULTS: Fifty-two (7.2%) and 57/718 (7.9%) patients were scored as moderate/severe bleeders and faecal incontinents, respectively; 19/57 incontinent patients showed persistent incontinence at 36 months. Bleeding was mainly correlated with V75 Gy while severe bleeding was mainly correlated with the previous abdominal/pelvic surgery; a different rectal dose-volume relationship in the two groups of patients (with/without surgery) was found. Moderate/severe acute toxicity was weakly correlated to late bleeding. The best predictor of faecal incontinence was acute toxicity (OR=4 and 7 for chronic and actuarial incontinence, respectively). CONCLUSION: The application of rectal dose-volume constraints limited the incidence of rectal bleeding. The risk of bleeding may be further reduced by limiting V75 Gy<5% and, in the case of patients previously submitted to abdominal/pelvic surgery, V70 Gy<15-20%. Faecal incontinence seems to be mainly a consequential effect after acute toxicity.
机译：目的：评估大剂量适形放射治疗前列腺癌后晚期直肠毒性的预测指标。方法：1122名患者进入了一项前瞻性观察性多中心研究。通过自我报告的问卷评估晚期直肠毒性。分析了有关718/1132患者在36个月时的完整随访情况的出血和粪便失禁的结果。通过单因素和多因素逻辑分析研究了许多临床剂量参数与中度/重度毒性之间的相关性。结果：分别有52例（7.2％）和57/718例（7.9％）患者被分为中度/重度出血和大便失禁。 19/57个失禁患者在36个月时表现出持续性失禁。出血主要与V75 Gy有关，而严重出血主要与先前的腹部/骨盆手术有关。在两组患者（有/无手术）中发现了不同的直肠剂量-体积关系。中度/重度急性毒性与晚期出血弱相关。粪便失禁的最佳预测指标是急性毒性（慢性和精算失禁的OR分别为4和7）。结论：直肠剂量限制的应用限制了直肠出血的发生。通过限制V75 Gy <5％可以进一步降低出血的风险，对于先前接受腹部/骨盆手术的患者，V70 Gy <15-20％可以进一步降低出血的风险。粪便失禁似乎主要是急性毒性后的后果。

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