Chronic Gastrointestinal Toxicity after External-Beam Radiation Therapy for Prostate Cancer
Authors:
J. Šefrová 1; P. Paluska 1; K. Odrážka 2,3,4,5; V. Jirkovský 6
Authors place of work:
Klinika onkologie a radioterapie, FN Hradec Králové 2Multiscan s. r. o., Oddělení klinické a radiační onkologie, Pardubická krajská nemocnice, a. s., Pardubice 3Onkologická klinika 1. lékařské fakulty UK a VFN, Praha 4Radioterapeutická a onkologická klini
1
Published in the journal:
Klin Onkol 2009; 22(5): 233-241
Category:
Original Article
Summary
Backgrounds:
Chronic gastrointestinal (GI) toxicity is an important dose limiting factor of prostate cancer treatment. Its incidence varies with the dose of radiotherapy and the external beam treatment technique; however, there are also other factors that should be considered. Despite all the efforts to diminish the incidence, chronic toxicity still remains an adverse event which can affect the quality of life in patients after prostate cancer radiotherapy. Design: The aim of this review is to provide a detailed description of chronic GI toxicity after external beam radiation therapy for prostate cancer, its causes, development, symptoms and incidence in different treatment techniques, and to compare the development of GI toxicity from the beginning of curative prostate cancer radiotherapy to now. Conclusion: Thanks to up-to-date radiotherapy techniques, the incidence of chronic GI toxicity is relatively low despite high doses of about 80 Gy used in prostate cancer treatment. Further reduction of radiation complications could be achieved by using image-guided radiotherapy (IGRT), which enables more precise delivery of the radiation dose to the prostate, reduction of the margin around the clinical target volume (CTV) and the sparing of organs at risk.
Key words:
toxicity – radiotherapy – proctitis – prostate cancer
Zdroje
1. Al-Mamgani A, van Putten WL, Heemsbergen WD et al. Dutch multicenter dose escalation trial of radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2008; 72(4): 980–988.
2. Peeters ST, Heemsbergen WD, Koper PC et al. Dose response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy. J Clin Oncol 2006; 24(13): 1990–1996.
3. Zietman AL, DeSilvio ML, Slater JD et. al. Comparison of conventional dose vs high dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA 2005; 294(10): 1233–1239.
4. Dearnaley DP, Sydes MR, Graham JD et al. Escalated dose versus standard dose conformal radiotherapy in prostate cancer: first results from the MRC RT01 randomised controlled trial. Lancet Oncol 2007; 8(6): 475–487.
5. Zelefsky MJ, Leibel SA, Gaudin PB et al. Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer. Int J Radiat Oncol Biol Phys 1998; 41(3): 491–500.
6. Zelefsky MJ, Yamada Y, Fuks Z et al. Long term results of conformal radiotherapy for prostate cancer: impact of dose escalation on biochemical tumor control and distant metastases free survival outcomes. Int J Radiat Oncol Biol Phys 2008; 71(4): 1028–1033.
7. Jacob R, Hanlon AL, Horwitz EM et al. The relationship of increasing radiotherapy dose to reduced distant metastases and mortality in men with prostate cancer. Cancer 2004; 100(3): 538–543.
8. Perez CA, Brady LW, Halperin EC et al (eds). Principles and Practice of Radiation Oncology. 4th ed. Philadelphia: Lippincott Williams&Wilkins 2004: 357–361, 379–383.
9. Garg AK, Mai WY, McGary JE et al. Radiation proctopathy in the treatment of prostate cancer. Int J Radiat Oncol Biol Phys 2006; 66(5): 1294–1305.
10. Huang EH, Pollack A, Levy L et al. Late rectal toxicity: dose volume effects of conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2002; 54(5): 1314–1321.
11. Pilepich MV, Krall J, George FW et al. Treatment related morbidity in phase III RTOG studies of extended-field irradiation for carcinoma of the prostate. Int J Radiat Oncol Biol Phys 1984; 10(10): 1861–1867.
12. Cho KH, Lee CK, Levitt SH. Proctitis after conventional external radiation therapy for prostate cancer: importance of minimizing posterior rectal dose. Radiology 1995; 195(3): 699–703.
13. Gilinsky NH, Burns DG, Barbezat GO et al. The natural history of radiation induced proctosigmoiditis: an analysis of 88 patients. Q J Med 1983; 52(205): 40–53.
14. Teshima T, Hanks GE, Hanlon AL et al. Rectal bleeding after conformal 3D treatment of prostate cancer: time to occurrence, response to treatment and duration of morbidity. Int J Radiat Oncol Biol Phys 1997; 39(1): 77–83.
15. Hanlon AL, Schultheiss TE, Hunt MA et al. Chronic rectal bleeding after high dose conformal treatment of prostate cancer warrants modification of existing morbidity scales. Int J Radiat Oncol Biol Phys 1997; 38(1): 59–63.
16. Cox JD, Stetz J, Pajak TF et al. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995; 31(5): 1341–1346.
17. Pavy JJ, Denekamp J, Letschert J et al. EORTC Late Effects Working Group. Late Effects toxicity scoring: the SOMA scale. Int J Radiat Oncol Biol Phys 1995; 31(5): 1043–1047.
18. Wachter S, Gerstner N, Goldner G et al. Endoscopic scoring of late rectal mucosal damage after conformal radiotherapy for prostatic carcinoma. Radiother Oncol 2000; 54(1): 11–19.
19. Michalski JM, Winter K, Purdy JA et al. Toxicity after three-dimensional radiotherapy for prostate cancer on RTOG 9406 dose Level V. Int J Radiat Oncol Biol Phys 2005; 62(3): 706–713.
20. Peeters ST, Lebesque JV, Heemsbergen WD et al. Localized volume effects for late rectal and anal toxicity after radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2006; 64(4): 1151–1161.
21. Storey MR, Pollack A, Zagars G et al. Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 2000; 48(3): 635–642.
22. Boersma LJ, van den Brink M, Bruce AM et al. Estimation of the incidence of late bladder and rectum complications after high dose (70–78 GY) conformal radiotherapy for prostate cancer, using dose volume histograms. Int J Radiat Oncol Biol Phys 1998; 41(1): 83–92.
23. Fiorino C, Fellin G, Rancati T et al. Clinical and dosimetric predictors of late rectal syndrome after 3D-CRT for localized prostate cancer: preliminary results of a multicenter prospective study. Int J Radiat Oncol Biol Phys 2008; 70(4): 1130–1137.
24. Herold DM, Hanlon AL, Hanks GE. Diabetes mellitus: a predictor for late radiation morbidity. Int J Radiat Oncol Biol Phys 1999; 43(3): 475–479.
25. Peeters ST, Heemsbergen WD, van Putten WL et al. Acute and late complications after radiotherapy for prostate cancer: results of a multicenter randomized trial comparing 68 Gy to 78 Gy. Int J Radiat Oncol Biol Phys 2005; 61(4): 1019–1034.
26. Willett CG, Ooi CJ, Zietman AL et al. Acute and late toxicity of patients with inflammatory bowel disease undergoing irradiation for abdominal and pelvic neoplasms. Int J Radiat Oncol Biol Phys 2000; 46(4): 995–998.
27. Song DY, Lawrie WT, Abrams RA et al. Acute and late radiotherapy toxicity in patients with inflammatory bowel disease. Int J Radiat Oncol Biol Phys 2001; 51: 455–459.
28. Zelefsky MJ, Levin EJ, Hunt M et al. Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2008; 70(4): 1124–1129.
29. Heemsbergen WD, Peeters ST, Koper PC et al. Acute and late gastrointestinal toxicity after radiotherapy in prostate cancer patients: consequential late damage. Int J Radiat Oncol Biol Phys 2006; 66(1): 3–10.
30. Dearnaley DP, Khoo VS, Norman AR et al. Comparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer: a randomised trial. Lancet 1999; 353(9149): 267–272.
31. Lee CM, Lee RJ, Handrahan DL et al. Comparison of late rectal toxicity from conventional versus three-dimensional conformal radiotherapy for prostate cancer: analysis of clinical and dosimetric factors. Urology 2005; 65(1): 114–119.
32. Ataman F, Zurlo A, Artignan X et al. Late toxicity following conventional radiotherapy for prostate cancer: analysis of the EORTC trial 22863. Eur J Cancer 2004; 40(11): 1674–1681.
33. Smit WG, Helle PA, van Putten WL et al. Late radiation damage in prostate cancer patients treated by high dose external radiotherapy in relation to rectal dose. Int J Radiat Oncol Biol Phys 1990; 18(1): 23–29.
34. Al-Mamgani A, Heemsbergen WD, Peeters ST et al. Role of intensity-modulated radiotherapy in reducing toxicity in dose escalation for localized prostate cancer. Int J Radiat Oncol Biol Phys 2009; 73(3): 685–691.
35. Meijer GJ, de Klerk J, Bzdusek K et al. What CTV-to-PTV margins should be applied for prostate irradiation? Four-dimensional quantitative assessment using model based deformable image registration techniques. Int J Radiat Oncol Biol Phys 2008; 72(5): 1416–1425.
36. Bylund KC, Bayouth JE, Smith MC et al. Analysis of interfraction prostate motion using megavoltage cone beam computed tomography. Int J Radiat Oncol Biol Phys 2008; 72(3): 949–956.
37. Wong JR, Gao Z, Uematsu M et al. Interfractional prostate shifts: review of 1 870 computed tomography (CT) scans obtained during image-guided radiotherapy using CT-on-rails for the treatment of prostate cancer. Int J Radiat Oncol Biol Phys 2008; 72(5): 1396–1401.
38. Britton KR, Takai Y, Mitsuya M et al. Evaluation of inter- and intrafraction organ motion during intensity modulated radiation therapy (IMRT) for localized prostate cancer measured by a newly developed on-board image-guided system. Radiat Med 2005; 23(1): 14–24.
39. Beltran C, Herman MG, Davis BJ. Planning target margin calculations for prostate radiotherapy based on intrafraction and interfraction motion using four localization methods. Int J Radiat Oncol Biol Phys 2008; 70(1): 289–295.
40. Liang J, Wu Q, Yan D. The role of seminal vesicle motion in target margin assessment for online image-guided radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2009; 73(3): 935–943.
41. Mah D, Freedman G, Milestone B et al. Measurement of intrafractional prostate motion using magnetic resonance imaging. Int J Radiat Oncol Biol Phys 2002; 54(2): 568–575.
42. Skala M, Rosewall T, Dawson L et al. Patient-assessed late toxicity rates and principal component analysis after image-guided radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 2007; 68(3): 690–698.
43. Chung HT, Xia P, Chan LW et al. Does image-guided radiotherapy improve toxicity profile in whole pelvic treated high risk prostate cancer? Comparison between IG-IMRT and IMRT. Int J Radiat Oncol Biol Phys 2009; 73(1): 53–60.
Štítky
Paediatric clinical oncology Surgery Clinical oncologyČlánok vyšiel v časopise
Clinical Oncology
2009 Číslo 5
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Spasmolytic Effect of Metamizole
- Possibilities of Using Metamizole in the Treatment of Acute Primary Headaches
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
Najčítanejšie v tomto čísle
- Rectal Neuroendocrine Tumours
- Chronic Gastrointestinal Toxicity after External-Beam Radiation Therapy for Prostate Cancer
- Evaporation of Selected Cytotoxic Drugs and Permeation of Protective Gloves – Research into the Occupational Risks of Health Care Personnel Handling Hazardous Cytotoxic Drugs (CYTO Project)
- Proteomic Analysis of Cancer Cells