Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy
To study the correlations between the dose distributions in the anorectal region and late GI symptoms in patients treated for localized prostate carcinoma. Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 G...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2005-03, Vol.61 (4), p.1011-1018 |
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| container_title | International journal of radiation oncology, biology, physics |
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| creator | Heemsbergen, Wilma D. Hoogeman, Mischa S. Hart, Guus A.M. Lebesque, Joos V. Koper, Peter C.M. |
| description | To study the correlations between the dose distributions in the anorectal region and late GI symptoms in patients treated for localized prostate carcinoma.
Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 Gy. Data concerning GI symptoms were collected from questionnaires of 197 patients. The distributions of the anorectal region were projected on maps, and the dose parameters were calculated. The incidences of complaints were studied as a function of the dose–area parameters and clinical parameters, using a proportional hazard regression model. Finally, we tested a series of dose parameters originating from different parts of the anorectal region.
Analyzing the total region, only a statistically significant dose–area effect relation for bleeding was found (
p < 0.01). Defining subareas, we found effect relations for bleeding, soiling, fecal incontinence, and mucus loss. For bleeding and mucus loss, the strongest correlation was found for the dose received by the upper 70–80% of the anorectal region (
p < 0.01). For soiling and fecal incontinence, we found the strongest association with the dose to the lower 40–50% (
p < 0.05).
We found evidence that complaints originate from specific regions of the irradiated lower GI tract. Bleeding and mucus loss are probably related to irradiation of the upper part of the rectum. Soiling and fecal incontinence are more likely related to the dose to the anal canal and the lower part of the rectum. |
| doi_str_mv | 10.1016/j.ijrobp.2004.07.724 |
| format | Article |
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Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 Gy. Data concerning GI symptoms were collected from questionnaires of 197 patients. The distributions of the anorectal region were projected on maps, and the dose parameters were calculated. The incidences of complaints were studied as a function of the dose–area parameters and clinical parameters, using a proportional hazard regression model. Finally, we tested a series of dose parameters originating from different parts of the anorectal region.
Analyzing the total region, only a statistically significant dose–area effect relation for bleeding was found (
p < 0.01). Defining subareas, we found effect relations for bleeding, soiling, fecal incontinence, and mucus loss. For bleeding and mucus loss, the strongest correlation was found for the dose received by the upper 70–80% of the anorectal region (
p < 0.01). For soiling and fecal incontinence, we found the strongest association with the dose to the lower 40–50% (
p < 0.05).
We found evidence that complaints originate from specific regions of the irradiated lower GI tract. Bleeding and mucus loss are probably related to irradiation of the upper part of the rectum. Soiling and fecal incontinence are more likely related to the dose to the anal canal and the lower part of the rectum.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2004.07.724</identifier><identifier>PMID: 15752880</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Analysis of Variance ; CARCINOMAS ; Colic - etiology ; Defecation - radiation effects ; Diarrhea - etiology ; Dose-Response Relationship, Radiation ; Dose–effect relation ; Fecal Incontinence - etiology ; Gastrointestinal Diseases - etiology ; Gastrointestinal Hemorrhage - etiology ; GI toxicity ; Humans ; IRRADIATION ; Male ; PATIENTS ; Proportional Hazards Models ; PROSTATE ; Prostate cancer ; Prostatic Neoplasms - radiotherapy ; RADIATION DOSE DISTRIBUTIONS ; RADIATION DOSES ; Radiation Injuries - complications ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; RECTUM ; Rectum - radiation effects ; SURFACE CONTAMINATION ; SYMPTOMS ; TOXICITY</subject><ispartof>International journal of radiation oncology, biology, physics, 2005-03, Vol.61 (4), p.1011-1018</ispartof><rights>2005 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-aee23cb0167e4cbe7522b83d1d2b83ff92825a61192f7c740925398938e847873</citedby><cites>FETCH-LOGICAL-c419t-aee23cb0167e4cbe7522b83d1d2b83ff92825a61192f7c740925398938e847873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301604021303$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15752880$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/20696129$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Heemsbergen, Wilma D.</creatorcontrib><creatorcontrib>Hoogeman, Mischa S.</creatorcontrib><creatorcontrib>Hart, Guus A.M.</creatorcontrib><creatorcontrib>Lebesque, Joos V.</creatorcontrib><creatorcontrib>Koper, Peter C.M.</creatorcontrib><title>Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>To study the correlations between the dose distributions in the anorectal region and late GI symptoms in patients treated for localized prostate carcinoma.
Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 Gy. Data concerning GI symptoms were collected from questionnaires of 197 patients. The distributions of the anorectal region were projected on maps, and the dose parameters were calculated. The incidences of complaints were studied as a function of the dose–area parameters and clinical parameters, using a proportional hazard regression model. Finally, we tested a series of dose parameters originating from different parts of the anorectal region.
Analyzing the total region, only a statistically significant dose–area effect relation for bleeding was found (
p < 0.01). Defining subareas, we found effect relations for bleeding, soiling, fecal incontinence, and mucus loss. For bleeding and mucus loss, the strongest correlation was found for the dose received by the upper 70–80% of the anorectal region (
p < 0.01). For soiling and fecal incontinence, we found the strongest association with the dose to the lower 40–50% (
p < 0.05).
We found evidence that complaints originate from specific regions of the irradiated lower GI tract. Bleeding and mucus loss are probably related to irradiation of the upper part of the rectum. Soiling and fecal incontinence are more likely related to the dose to the anal canal and the lower part of the rectum.</description><subject>Analysis of Variance</subject><subject>CARCINOMAS</subject><subject>Colic - etiology</subject><subject>Defecation - radiation effects</subject><subject>Diarrhea - etiology</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Dose–effect relation</subject><subject>Fecal Incontinence - etiology</subject><subject>Gastrointestinal Diseases - etiology</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>GI toxicity</subject><subject>Humans</subject><subject>IRRADIATION</subject><subject>Male</subject><subject>PATIENTS</subject><subject>Proportional Hazards Models</subject><subject>PROSTATE</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>RADIATION DOSE DISTRIBUTIONS</subject><subject>RADIATION DOSES</subject><subject>Radiation Injuries - complications</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>RECTUM</subject><subject>Rectum - radiation effects</subject><subject>SURFACE CONTAMINATION</subject><subject>SYMPTOMS</subject><subject>TOXICITY</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc-KFDEQxoMo7uzqG4gEBG_d5l93ui-CLLorLHhR8BbSSbWToafTJhnXeQmf2Wp6wJunQNWvvtRXHyGvOKs54-27Qx0OKQ5LLRhTNdO1FuoJ2fFO95Vsmu9PyY7JllUS4StynfOBMca5Vs_JFW90I7qO7cifO5tLimEukEuY7URL_B1cKGdqZ09DyTTBZEuIM3aojxmoDzgShtNazDRgYw9IxwSuoECCHysdR7qkmIstQJ2dHSS6oA7MKFkSYNnTx1D2NFkfIkoku5xfkGejnTK8vLw35Nunj19v76uHL3efbz88VE7xvlQWQEg3oDMNyg2AbsTQSc_9-oxjLzrR2JbzXozaacV60ci-62UHndKdljfkzaaLCwaT0S-4vYvzjBaMYG3fctEj9Xaj0MjPEx7IHEN2ME12hnjKCDaylUoiqDbQoeOcYDRLCkebzoYzs6ZlDmZLy6xpGaYNpoVjry_6p-EI_t_QJR4E3m8A4C1-BUjrqoC39GE9tvEx_P-Hv6-Lquk</recordid><startdate>20050315</startdate><enddate>20050315</enddate><creator>Heemsbergen, Wilma D.</creator><creator>Hoogeman, Mischa S.</creator><creator>Hart, Guus A.M.</creator><creator>Lebesque, Joos V.</creator><creator>Koper, Peter C.M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>OTOTI</scope></search><sort><creationdate>20050315</creationdate><title>Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy</title><author>Heemsbergen, Wilma D. ; Hoogeman, Mischa S. ; Hart, Guus A.M. ; Lebesque, Joos V. ; Koper, Peter C.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-aee23cb0167e4cbe7522b83d1d2b83ff92825a61192f7c740925398938e847873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Analysis of Variance</topic><topic>CARCINOMAS</topic><topic>Colic - etiology</topic><topic>Defecation - radiation effects</topic><topic>Diarrhea - etiology</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Dose–effect relation</topic><topic>Fecal Incontinence - etiology</topic><topic>Gastrointestinal Diseases - etiology</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>GI toxicity</topic><topic>Humans</topic><topic>IRRADIATION</topic><topic>Male</topic><topic>PATIENTS</topic><topic>Proportional Hazards Models</topic><topic>PROSTATE</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>RADIATION DOSE DISTRIBUTIONS</topic><topic>RADIATION DOSES</topic><topic>Radiation Injuries - complications</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>RECTUM</topic><topic>Rectum - radiation effects</topic><topic>SURFACE CONTAMINATION</topic><topic>SYMPTOMS</topic><topic>TOXICITY</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heemsbergen, Wilma D.</creatorcontrib><creatorcontrib>Hoogeman, Mischa S.</creatorcontrib><creatorcontrib>Hart, Guus A.M.</creatorcontrib><creatorcontrib>Lebesque, Joos V.</creatorcontrib><creatorcontrib>Koper, Peter C.M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heemsbergen, Wilma D.</au><au>Hoogeman, Mischa S.</au><au>Hart, Guus A.M.</au><au>Lebesque, Joos V.</au><au>Koper, Peter C.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2005-03-15</date><risdate>2005</risdate><volume>61</volume><issue>4</issue><spage>1011</spage><epage>1018</epage><pages>1011-1018</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>To study the correlations between the dose distributions in the anorectal region and late GI symptoms in patients treated for localized prostate carcinoma.
Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 Gy. Data concerning GI symptoms were collected from questionnaires of 197 patients. The distributions of the anorectal region were projected on maps, and the dose parameters were calculated. The incidences of complaints were studied as a function of the dose–area parameters and clinical parameters, using a proportional hazard regression model. Finally, we tested a series of dose parameters originating from different parts of the anorectal region.
Analyzing the total region, only a statistically significant dose–area effect relation for bleeding was found (
p < 0.01). Defining subareas, we found effect relations for bleeding, soiling, fecal incontinence, and mucus loss. For bleeding and mucus loss, the strongest correlation was found for the dose received by the upper 70–80% of the anorectal region (
p < 0.01). For soiling and fecal incontinence, we found the strongest association with the dose to the lower 40–50% (
p < 0.05).
We found evidence that complaints originate from specific regions of the irradiated lower GI tract. Bleeding and mucus loss are probably related to irradiation of the upper part of the rectum. Soiling and fecal incontinence are more likely related to the dose to the anal canal and the lower part of the rectum.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15752880</pmid><doi>10.1016/j.ijrobp.2004.07.724</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2005-03, Vol.61 (4), p.1011-1018 |
| issn | 0360-3016 1879-355X |
| language | eng |
| recordid | cdi_osti_scitechconnect_20696129 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Analysis of Variance CARCINOMAS Colic - etiology Defecation - radiation effects Diarrhea - etiology Dose-Response Relationship, Radiation Dose–effect relation Fecal Incontinence - etiology Gastrointestinal Diseases - etiology Gastrointestinal Hemorrhage - etiology GI toxicity Humans IRRADIATION Male PATIENTS Proportional Hazards Models PROSTATE Prostate cancer Prostatic Neoplasms - radiotherapy RADIATION DOSE DISTRIBUTIONS RADIATION DOSES Radiation Injuries - complications RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY RECTUM Rectum - radiation effects SURFACE CONTAMINATION SYMPTOMS TOXICITY |
| title | Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy |
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