Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding
To investigate the incidence and severity of rectal bleeding after high-dose hypofractionated radiotherapy (RT) for prostate cancer, and to explore the factors affecting the incidence of Grade 2 or worse rectal bleeding. The data of 52 patients who had been treated by external beam RT for localized...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2004-11, Vol.60 (4), p.1033-1039 |
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| creator | Akimoto, Tetsuo Muramatsu, Hiroyuki Takahashi, Mitsuhiro Saito, Jun-ichi Kitamoto, Yoshizumi Harashima, Koichi Miyazawa, Yasushi Yamada, Masami Ito, Kazuto Kurokawa, Kouhei Yamanaka, Hidetoshi Nakano, Takashi Mitsuhashi, Norio Niibe, Hideo |
| description | To investigate the incidence and severity of rectal bleeding after high-dose hypofractionated radiotherapy (RT) for prostate cancer, and to explore the factors affecting the incidence of Grade 2 or worse rectal bleeding.
The data of 52 patients who had been treated by external beam RT for localized prostate cancer between 1999 and 2002 were analyzed. All the patients had received hypofractionated external beam RT to a total dose of 69 Gy in 3-Gy fractions, three fractions weekly. The clinical and dosimetric factors affecting the incidence of Grade 2 or worse late rectal bleeding were analyzed by univariate and multivariate analyses. The effect of the percentage of the whole rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose (V
30, V
50, V
80, and V
90, respectively) on the incidence of rectal bleeding was evaluated.
Of the 52 patients, 13 (25%) developed Grade 2 or worse rectal bleeding. One patient who needed laser coagulation and blood transfusion for the treatment of rectal bleeding was classified as having Grade 3 rectal bleeding. The median time to the development of Grade 2 or worse rectal bleeding was 11 months. The results of the univariate analysis revealed that the presence of a history of diabetes mellitus (
p < 0.001), and V
30 ≥ 60%, V
50 ≥ 40% (
p < 0.05), V
80 ≥ 25%, and V
90 ≥ 15% (
p < 0.001) were statistically significant risk factors for the occurrence of Grade 2 or worse rectal bleeding. The results of the multivariate analysis revealed that a history of diabetes mellitus was the most statistically significant risk factor for the occurrence of rectal bleeding after hypofractionated RT for prostate cancer (
p < 0.05).
A history of diabetes mellitus was the most statistically significant risk factor for the occurrence of Grade 2 or worse rectal bleeding after high-dose hypofractionated RT, although dosimetric factors were also closely associated with the risk of rectal bleeding. |
| doi_str_mv | 10.1016/j.ijrobp.2004.07.695 |
| format | Article |
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The data of 52 patients who had been treated by external beam RT for localized prostate cancer between 1999 and 2002 were analyzed. All the patients had received hypofractionated external beam RT to a total dose of 69 Gy in 3-Gy fractions, three fractions weekly. The clinical and dosimetric factors affecting the incidence of Grade 2 or worse late rectal bleeding were analyzed by univariate and multivariate analyses. The effect of the percentage of the whole rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose (V
30, V
50, V
80, and V
90, respectively) on the incidence of rectal bleeding was evaluated.
Of the 52 patients, 13 (25%) developed Grade 2 or worse rectal bleeding. One patient who needed laser coagulation and blood transfusion for the treatment of rectal bleeding was classified as having Grade 3 rectal bleeding. The median time to the development of Grade 2 or worse rectal bleeding was 11 months. The results of the univariate analysis revealed that the presence of a history of diabetes mellitus (
p < 0.001), and V
30 ≥ 60%, V
50 ≥ 40% (
p < 0.05), V
80 ≥ 25%, and V
90 ≥ 15% (
p < 0.001) were statistically significant risk factors for the occurrence of Grade 2 or worse rectal bleeding. The results of the multivariate analysis revealed that a history of diabetes mellitus was the most statistically significant risk factor for the occurrence of rectal bleeding after hypofractionated RT for prostate cancer (
p < 0.05).
A history of diabetes mellitus was the most statistically significant risk factor for the occurrence of Grade 2 or worse rectal bleeding after high-dose hypofractionated RT, although dosimetric factors were also closely associated with the risk of rectal bleeding.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2004.07.695</identifier><identifier>PMID: 15519772</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Analysis of Variance ; Biological and medical sciences ; Diabetes Complications ; Diabetes mellitus ; Dose Fractionation ; Gastrointestinal Hemorrhage - epidemiology ; Gastrointestinal Hemorrhage - etiology ; Humans ; Hypofractionated radiotherapy ; Incidence ; Male ; Medical sciences ; Middle Aged ; Prostate cancer ; Prostatic Neoplasms - radiotherapy ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Rectal bleeding ; Rectal Diseases - epidemiology ; Rectal Diseases - etiology ; Rectum - radiation effects ; Risk Factors ; Technology. Biomaterials. Equipments. Material. Instrumentation</subject><ispartof>International journal of radiation oncology, biology, physics, 2004-11, Vol.60 (4), p.1033-1039</ispartof><rights>2004 Elsevier Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-5a14dc3d80f21b30288c58eb215800447e56a2cf98937201290ad31a65add6733</citedby><cites>FETCH-LOGICAL-c454t-5a14dc3d80f21b30288c58eb215800447e56a2cf98937201290ad31a65add6733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2004.07.695$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16265190$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15519772$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akimoto, Tetsuo</creatorcontrib><creatorcontrib>Muramatsu, Hiroyuki</creatorcontrib><creatorcontrib>Takahashi, Mitsuhiro</creatorcontrib><creatorcontrib>Saito, Jun-ichi</creatorcontrib><creatorcontrib>Kitamoto, Yoshizumi</creatorcontrib><creatorcontrib>Harashima, Koichi</creatorcontrib><creatorcontrib>Miyazawa, Yasushi</creatorcontrib><creatorcontrib>Yamada, Masami</creatorcontrib><creatorcontrib>Ito, Kazuto</creatorcontrib><creatorcontrib>Kurokawa, Kouhei</creatorcontrib><creatorcontrib>Yamanaka, Hidetoshi</creatorcontrib><creatorcontrib>Nakano, Takashi</creatorcontrib><creatorcontrib>Mitsuhashi, Norio</creatorcontrib><creatorcontrib>Niibe, Hideo</creatorcontrib><title>Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>To investigate the incidence and severity of rectal bleeding after high-dose hypofractionated radiotherapy (RT) for prostate cancer, and to explore the factors affecting the incidence of Grade 2 or worse rectal bleeding.
The data of 52 patients who had been treated by external beam RT for localized prostate cancer between 1999 and 2002 were analyzed. All the patients had received hypofractionated external beam RT to a total dose of 69 Gy in 3-Gy fractions, three fractions weekly. The clinical and dosimetric factors affecting the incidence of Grade 2 or worse late rectal bleeding were analyzed by univariate and multivariate analyses. The effect of the percentage of the whole rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose (V
30, V
50, V
80, and V
90, respectively) on the incidence of rectal bleeding was evaluated.
Of the 52 patients, 13 (25%) developed Grade 2 or worse rectal bleeding. One patient who needed laser coagulation and blood transfusion for the treatment of rectal bleeding was classified as having Grade 3 rectal bleeding. The median time to the development of Grade 2 or worse rectal bleeding was 11 months. The results of the univariate analysis revealed that the presence of a history of diabetes mellitus (
p < 0.001), and V
30 ≥ 60%, V
50 ≥ 40% (
p < 0.05), V
80 ≥ 25%, and V
90 ≥ 15% (
p < 0.001) were statistically significant risk factors for the occurrence of Grade 2 or worse rectal bleeding. The results of the multivariate analysis revealed that a history of diabetes mellitus was the most statistically significant risk factor for the occurrence of rectal bleeding after hypofractionated RT for prostate cancer (
p < 0.05).
A history of diabetes mellitus was the most statistically significant risk factor for the occurrence of Grade 2 or worse rectal bleeding after high-dose hypofractionated RT, although dosimetric factors were also closely associated with the risk of rectal bleeding.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Diabetes Complications</subject><subject>Diabetes mellitus</subject><subject>Dose Fractionation</subject><subject>Gastrointestinal Hemorrhage - epidemiology</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>Humans</subject><subject>Hypofractionated radiotherapy</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Rectal bleeding</subject><subject>Rectal Diseases - epidemiology</subject><subject>Rectal Diseases - etiology</subject><subject>Rectum - radiation effects</subject><subject>Risk Factors</subject><subject>Technology. Biomaterials. Equipments. Material. Instrumentation</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGKFDEQhoMo7uzqG4jkorduk3Qn6fYgyKCrsCCIgreQTqp3M_R02iTjMg_m-1ntDCxePCVQX_1V9f-EvOCs5oyrN7s67FIcllow1tZM16qXj8iGd7qvGil_PCYb1ihWNQhfkMucd4wxznX7lFxwKXmvtdiQ31_BFTvRYQLwYb6ldiyQ6N1xiWOyroQ42wKeJutDLHeQ7HKkY0x0STEXLFFnZwfpLd3GlGCyawcdoNwDzNRNYQ4O5e3sqY857KGk4Ohik8UvpPy3gro0zC54QCkaR3qL44AKinPuY8pA079bPiNPRjtleH5-r8j3jx--bT9VN1-uP2_f31SulW2ppOWtd43v2Cj40DDRdU52MAguOzSt1SCVFW7su77RgnHRM-sbbpW03ivdNFfk9UkXr_15gFzMPmQH02RniIdslGZC6b5DsD2BDm3JCUazpLC36Wg4M2tcZmdOcZk1LsO0wbiw7eVZ_zDswT80nfNB4NUZsBl9xEjQpvzAKaGQZMi9O3GAbvwKkEx2YXXTh9U642P4_yZ_AFmIuSI</recordid><startdate>20041115</startdate><enddate>20041115</enddate><creator>Akimoto, Tetsuo</creator><creator>Muramatsu, Hiroyuki</creator><creator>Takahashi, Mitsuhiro</creator><creator>Saito, Jun-ichi</creator><creator>Kitamoto, Yoshizumi</creator><creator>Harashima, Koichi</creator><creator>Miyazawa, Yasushi</creator><creator>Yamada, Masami</creator><creator>Ito, Kazuto</creator><creator>Kurokawa, Kouhei</creator><creator>Yamanaka, Hidetoshi</creator><creator>Nakano, Takashi</creator><creator>Mitsuhashi, Norio</creator><creator>Niibe, Hideo</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><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>7X8</scope></search><sort><creationdate>20041115</creationdate><title>Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding</title><author>Akimoto, Tetsuo ; Muramatsu, Hiroyuki ; Takahashi, Mitsuhiro ; Saito, Jun-ichi ; Kitamoto, Yoshizumi ; Harashima, Koichi ; Miyazawa, Yasushi ; Yamada, Masami ; Ito, Kazuto ; Kurokawa, Kouhei ; Yamanaka, Hidetoshi ; Nakano, Takashi ; Mitsuhashi, Norio ; Niibe, Hideo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-5a14dc3d80f21b30288c58eb215800447e56a2cf98937201290ad31a65add6733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Diabetes Complications</topic><topic>Diabetes mellitus</topic><topic>Dose Fractionation</topic><topic>Gastrointestinal Hemorrhage - epidemiology</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Humans</topic><topic>Hypofractionated radiotherapy</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Rectal bleeding</topic><topic>Rectal Diseases - epidemiology</topic><topic>Rectal Diseases - etiology</topic><topic>Rectum - radiation effects</topic><topic>Risk Factors</topic><topic>Technology. Biomaterials. Equipments. Material. Instrumentation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akimoto, Tetsuo</creatorcontrib><creatorcontrib>Muramatsu, Hiroyuki</creatorcontrib><creatorcontrib>Takahashi, Mitsuhiro</creatorcontrib><creatorcontrib>Saito, Jun-ichi</creatorcontrib><creatorcontrib>Kitamoto, Yoshizumi</creatorcontrib><creatorcontrib>Harashima, Koichi</creatorcontrib><creatorcontrib>Miyazawa, Yasushi</creatorcontrib><creatorcontrib>Yamada, Masami</creatorcontrib><creatorcontrib>Ito, Kazuto</creatorcontrib><creatorcontrib>Kurokawa, Kouhei</creatorcontrib><creatorcontrib>Yamanaka, Hidetoshi</creatorcontrib><creatorcontrib>Nakano, Takashi</creatorcontrib><creatorcontrib>Mitsuhashi, Norio</creatorcontrib><creatorcontrib>Niibe, Hideo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akimoto, Tetsuo</au><au>Muramatsu, Hiroyuki</au><au>Takahashi, Mitsuhiro</au><au>Saito, Jun-ichi</au><au>Kitamoto, Yoshizumi</au><au>Harashima, Koichi</au><au>Miyazawa, Yasushi</au><au>Yamada, Masami</au><au>Ito, Kazuto</au><au>Kurokawa, Kouhei</au><au>Yamanaka, Hidetoshi</au><au>Nakano, Takashi</au><au>Mitsuhashi, Norio</au><au>Niibe, Hideo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2004-11-15</date><risdate>2004</risdate><volume>60</volume><issue>4</issue><spage>1033</spage><epage>1039</epage><pages>1033-1039</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>To investigate the incidence and severity of rectal bleeding after high-dose hypofractionated radiotherapy (RT) for prostate cancer, and to explore the factors affecting the incidence of Grade 2 or worse rectal bleeding.
The data of 52 patients who had been treated by external beam RT for localized prostate cancer between 1999 and 2002 were analyzed. All the patients had received hypofractionated external beam RT to a total dose of 69 Gy in 3-Gy fractions, three fractions weekly. The clinical and dosimetric factors affecting the incidence of Grade 2 or worse late rectal bleeding were analyzed by univariate and multivariate analyses. The effect of the percentage of the whole rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose (V
30, V
50, V
80, and V
90, respectively) on the incidence of rectal bleeding was evaluated.
Of the 52 patients, 13 (25%) developed Grade 2 or worse rectal bleeding. One patient who needed laser coagulation and blood transfusion for the treatment of rectal bleeding was classified as having Grade 3 rectal bleeding. The median time to the development of Grade 2 or worse rectal bleeding was 11 months. The results of the univariate analysis revealed that the presence of a history of diabetes mellitus (
p < 0.001), and V
30 ≥ 60%, V
50 ≥ 40% (
p < 0.05), V
80 ≥ 25%, and V
90 ≥ 15% (
p < 0.001) were statistically significant risk factors for the occurrence of Grade 2 or worse rectal bleeding. The results of the multivariate analysis revealed that a history of diabetes mellitus was the most statistically significant risk factor for the occurrence of rectal bleeding after hypofractionated RT for prostate cancer (
p < 0.05).
A history of diabetes mellitus was the most statistically significant risk factor for the occurrence of Grade 2 or worse rectal bleeding after high-dose hypofractionated RT, although dosimetric factors were also closely associated with the risk of rectal bleeding.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15519772</pmid><doi>10.1016/j.ijrobp.2004.07.695</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2004-11, Vol.60 (4), p.1033-1039 |
| issn | 0360-3016 1879-355X |
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| subjects | Aged Aged, 80 and over Analysis of Variance Biological and medical sciences Diabetes Complications Diabetes mellitus Dose Fractionation Gastrointestinal Hemorrhage - epidemiology Gastrointestinal Hemorrhage - etiology Humans Hypofractionated radiotherapy Incidence Male Medical sciences Middle Aged Prostate cancer Prostatic Neoplasms - radiotherapy Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Rectal bleeding Rectal Diseases - epidemiology Rectal Diseases - etiology Rectum - radiation effects Risk Factors Technology. Biomaterials. Equipments. Material. Instrumentation |
| title | Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding |
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