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Type: Journal article
Title: Anorectal function after three- versus two-dimensional radiation therapy for carcinoma of the prostate
Author: Yeoh, E.
Holloway, R.
Fraser, R.
Botten, R.
Di Matteo, A.
Moore, J.
Schoeman, M.
Bartholomeusz, F.
Citation: International Journal of Radiation: Oncology - Biology - Physics, 2009; 73(1):46-52
Publisher: Elsevier Science Inc
Issue Date: 2009
ISSN: 0360-3016
Statement of
Eric K. Yeoh, Richard H. Holloway, Robert J. Fraser, Rochelle Botten, Addolorata Di Matteo, James W. Moore, Mark N. Schoeman and Dylan L. Bartholomeusz
Abstract: <h4>Purpose</h4>To compare the effects of (three-dimensional) 3D vs. two-dimensional (2D) radiation therapy (RT) for carcinoma of the prostate on the prevalence and pathophysiology of anorectal dysfunction.<h4>Methods and materials</h4>Anorectal symptoms, motility, sensory function, and anal sphincter morphology were evaluated before and up to 2 years after randomly assigned hypofractionated vs. conventionally fractionated RT in 67 patients (median age, 69 years; range, 54-82 years) with localized prostate carcinoma, using either a 3D (n = 29) or 2D (n = 38) treatment technique.<h4>Results</h4>Anorectal symptoms increased 4 to 6 weeks after RT and persisted in both patient groups. At 2 years, abnormalities included increased stool frequency (55% vs. 53%, p = NS), urgency of defecation (72% vs. 47%, p < 0.05), fecal incontinence (28% vs. 26%, p = NS), and rectal bleeding (38% and 42%, p = NS). Anorectal motility and sensory function deteriorated after RT in both groups with reductions in basal anal pressures, anal pressures in response to squeeze, rectal compliance, and rectal volumes associated with the desire to defecate. External but not internal sphincter thickness changed in the treatment groups although in different directions. However no differences in motility or sensory function were detected between the groups. Baseline anorectal motility but not treatment technique and the hypofracionated schedule were of independent prognostic significance for anorectal motor dysfunction and rectal bleeding respectively at 2 years.<h4>Conclusion</h4>The prevalence and pathophysiology of anorectal dysfunction 2 years after RT for prostate carcinoma was largely independent of the treatment techniques used in this study.
Keywords: Humans
Prostatic Neoplasms
Rectal Diseases
Anus Diseases
Radiation Injuries
Treatment Outcome
Radiotherapy, Conformal
Risk Assessment
Risk Factors
Aged, 80 and over
Middle Aged
Rights: © 2009 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.ijrobp.2008.03.058
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