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Volume 18, Number 5, 2013

Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results

Rafael Fuentes-Raspall, José Maria Inoriza, Alvaro Rosello-Serrano,
Carmen Aun˜ ón-Sanza,  Pilar Garcia-Martin, Gemma Oliu-Isern


Aim: This study aimed at investigating factors associated to late rectal and bladder toxicity
following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2.
Background: Radiation is frequently used for prostate cancer, but a 5–20% incidence of late
radiation proctitis and cystitis exists. Some clinical and dosimetric factors have been defined
without a full agreement. For patients diagnosed of late chronic proctitis and/or cystitis grade
≥2 treatment is not well defined. Hyperbaric Oxygen Therapy (HBOT) has been used, but its
effectiveness is not well known.
Materials and methods: 257 patients were treated with radiation therapy for prostate cancer.
Clinical, pharmacological and dosimetric parameters were collected. Patients having a
grade ≥2 toxicity were treated with HBOT. Results of the intervention were measured by
monitoring toxicity by Common Toxicity Criteria v3 (CTCv3).
Results: Late rectal toxicity was related to the volume irradiated, i.e. V50 > 53.64 (p = 0.013);
V60 > 38.59% (p = 0.005); V65 > 31.09% (p = 0.002) and V70 > 22.81% (p = 0.012). We could not
correlate the volume for bladder. A total of 24 (9.3%) patients experienced a grade ≥2. Only
the use of dicumarinic treatment was significant for late rectal toxicity (p = 0.014). A total of
14 patients needed HBOT. Final percentage of patients with a persistent toxicity grade ≥2
was 4.5%.
Conclusion: Rectal volume irradiated and dicumarinic treatment were associated to late rectal/
bladder toxicity. When toxicity grade ≥2 is diagnosed, HBOT significantly ameliorate

Signature: Rep Pract Oncol Radiother, 2013; 18(5) : 298-303

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