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Pathophysiology and natural history of anorectal sequelae following 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.authorButters, J.
dc.date.issued2012
dc.description.abstract<h4>Purpose</h4>To characterize the prevalence, pathophysiology, and natural history of chronic radiation proctitis 5 years following radiation therapy (RT) for localized carcinoma of the prostate.<h4>Methods and materials</h4>Studies were performed in 34 patients (median age 68 years; range 54-79) previously randomly assigned to either 64 Gy in 32 fractions over 6.4 weeks or 55 Gy in 20 fractions over 4 weeks RT schedule using 2- and later 3-dimensional treatment technique for localized prostate carcinoma. Each patient underwent evaluations of (1) gastrointestinal (GI) symptoms (Modified Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scales including effect on activities of daily living [ADLs]); (2) anorectal motor and sensory function (manometry and graded balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before RT, at 1 month, and annually for 5 years after its completion.<h4>Results</h4>Total GI symptom scores increased after RT and remained above baseline levels at 5 years and were associated with reductions in (1) basal anal pressures, (2) responses to squeeze and increased intra-abdominal pressure, (3) rectal compliance and (4) rectal volumes of sensory perception. Anal sphincter morphology was unchanged. At 5 years, 44% and 21% of patients reported urgency of defecation and rectal bleeding, respectively, and 48% impairment of ADLs. GI symptom scores and parameters of anorectal function and anal sphincter morphology did not differ between the 2 RT schedules or treatment techniques.<h4>Conclusions</h4>Five years after RT for prostate carcinoma, anorectal symptoms continue to have a significant impact on ADLs of almost 50% of patients. These symptoms are associated with anorectal dysfunction independent of the RT schedules or treatment techniques reported here.
dc.description.statementofresponsibilityEric K. Yeoh, Richard H. Holloway, Robert J. Fraser, Rochelle J. Botten, Addolorata C. Di Matteo, Julie Butters
dc.identifier.citationInternational Journal of Radiation: Oncology - Biology - Physics, 2012; 84(5):E593-E599
dc.identifier.doi10.1016/j.ijrobp.2012.06.032
dc.identifier.issn0360-3016
dc.identifier.issn1879-355X
dc.identifier.urihttp://hdl.handle.net/2440/76265
dc.language.isoen
dc.publisherElsevier Science Inc
dc.rightsCrown copyright © 2012 Published by Elsevier Inc. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.ijrobp.2012.06.032
dc.subjectRectum
dc.subjectHumans
dc.subjectCarcinoma
dc.subjectProstatic Neoplasms
dc.subjectProctitis
dc.subjectRadiation Injuries
dc.subjectUltrasonography
dc.subjectReflex
dc.subjectRadiotherapy Dosage
dc.subjectActivities of Daily Living
dc.subjectProspective Studies
dc.subjectSensation
dc.subjectPressure
dc.subjectTime Factors
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectAnal Canal
dc.subjectMale
dc.titlePathophysiology and natural history of anorectal sequelae following radiation therapy for carcinoma of the prostate
dc.typeJournal article
pubs.publication-statusPublished

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