Anorectal function after three- versus two-dimensional radiation therapy for carcinoma of the prostate

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dc.contributor.authorYeoh, E.
dc.contributor.authorHolloway, R.
dc.contributor.authorFraser, R.
dc.contributor.authorBotten, R.
dc.contributor.authorDi Matteo, A.
dc.contributor.authorMoore, J.
dc.contributor.authorSchoeman, M.
dc.contributor.authorBartholomeusz, F.
dc.date.issued2009
dc.description.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.
dc.description.statementofresponsibilityEric K. Yeoh, Richard H. Holloway, Robert J. Fraser, Rochelle Botten, Addolorata Di Matteo, James W. Moore, Mark N. Schoeman and Dylan L. Bartholomeusz
dc.identifier.citationInternational Journal of Radiation: Oncology - Biology - Physics, 2009; 73(1):46-52
dc.identifier.doi10.1016/j.ijrobp.2008.03.058
dc.identifier.issn0360-3016
dc.identifier.issn1879-355X
dc.identifier.urihttp://hdl.handle.net/2440/53525
dc.language.isoen
dc.publisherElsevier Science Inc
dc.rights© 2009 Elsevier Inc. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.ijrobp.2008.03.058
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectRectal Diseases
dc.subjectAnus Diseases
dc.subjectRadiation Injuries
dc.subjectTreatment Outcome
dc.subjectRadiotherapy, Conformal
dc.subjectIncidence
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectComorbidity
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectAustralia
dc.subjectMale
dc.titleAnorectal function after three- versus two-dimensional radiation therapy for carcinoma of the prostate
dc.typeJournal article
pubs.publication-statusPublished

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