- 作者：Edy Ippolito ; M.D.&lowast ; ; Mariangela Massaccesi ; M.D.&lowast ; ; Cinzia Digesù ; M.D.&lowast ; ; Francesco Deodato ; M.D.&lowast ; ; Gabriella Macchia ; M.D.&lowast ; ; gmacchia@rm.unicatt.it ; Giuseppe Antonio Pirozzi ; M.D.&dagger ; ; Savino Cilla ; M.P.§ ; ; Daniele Cuscunà ; M.D.¶ ; ; Alessandra Di Lallo ; M.D.¶ ; ; Gian Carlo Mattiucci ; M.D.鈥?/sup> ; Giovanna Mantini ; M.D.鈥?/sup> ; Fabio Pacelli ; M.D.&Dagger ; ; Vincenzo Valentini ; M.D.鈥?/sup> ; Numa Cellini ; M.D.鈥?/sup> ; Marcello Ingrosso ; M.D.&dagger ; ; Alessio Giuseppe Morganti ; M.D.&lowast ; ; 鈥?/sup>
- 关键词：Prostate cancer ; Radiotherapy ; Proctoscopy ; Late toxicity ; Rectal bleeding ; Surrogate endpoint
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 期刊代码：136_03603016
- 类别：med
- 出版时间：1 June, 2012
- 卷：83
- 期：2
- 页码：e191-e195
- 文件大小：221 K
Purpose
To predict the grade and incidence of late clinical rectal toxicity through short-term (1 year) mucosal alterations.Methods and Materials
Patients with prostate adenocarcinoma treated with curative or adjuvant radiotherapy underwent proctoscopy a year after the course of radiotherapy. Mucosal changes were classified by the Vienna Rectoscopy Score (VRS). Late toxicity data were analyzed according to the Kaplan-Meier method. Comparison between prognosis groups was performed by log-rank analysis.
Results
After a median follow-up time of 45 months (range, 18-99), the 3-year incidence of grade 鈮? rectal late toxicity according to the criteria of the European Organization for Research and Treatment of Cancer and the Radiation Therapy Oncology Group was 24%, with all patients (24/24; 100%) experiencing rectal bleeding. The occurrence of grade 鈮? clinical rectal late toxicity was higher in patients with grade 鈮? (32%vs. 15%, p = 0.02) or grade 鈮? VRS telangiectasia (47%vs. 17%, p 鈮?0.01) and an overall VRS score of 鈮? (31%vs. 16%, p聽= 0.04) or 鈮? (48%vs. 17%, p = 0.01) at the 1-year proctoscopy.
Conclusions
Early proctoscopy (1 year) predicts late rectal bleeding and therefore can be used as a surrogate endpoint for late rectal toxicity in studies aimed at reducing this frequent complication.