Role of Early Proctoscopy in Predicting Late Symptomatic Proctitis After External Radiation Therapy for Prostate Carcinoma
Role of Early Proctoscopy in Predicting Late Symptomatic Proctitis After External Radiation Therapy for Prostate Carcinoma
复制标题
DOI：
10.1016/j.ijrobp.2012.07.2373
复制
发表时间：
2013-03-15
影响因子：
7
通讯作者：
Verlato, Giuseppe
中科院分区：
文献类型：
--
作者：
Campostrini, Franco;Musola, Renato;Verlato, Giuseppe
目的：为了确定是否急性放射性直肠炎，诊断直肠镜放射治疗后的前列腺癌，可以预测晚期临床直肠炎。方法和材料：130例患者接受外部放射治疗（RT）的T1至T4期前列腺癌在1997年和2008年之间进行了前瞻性研究。61例患者的治疗为常规治疗（二维[2D]），69例患者为三维适形治疗，中位靶剂量为72戈伊（70-74戈伊）。RT后1周内，进行直肠镜检查以检测可能的急性内镜下直肠炎（AEP）。还评价了急性临床直肠炎（ACP）和晚期临床直肠炎（LCP）。中位随访时间为84个月（20-180个月）。结果：15例（11.5%）患者检测到AEP，67例（51.5%）检测到ACP，13例（10%）患者同时发生AEP和ACP。记录了35例LCP。AEP和ACP患者发生LCP的5年概率最高（77%，95%置信区间[CI] 53%-94%），无症状患者最低（14%，95% CI 7%-26%; P
Purpose: To determine whether acute radiation-proctitis, diagnosed by proctoscopy after radiation therapy for prostate cancer, can predict late clinical proctitis.Methods and Materials: A prospective study of 130 patients who underwent external radiation therapy (RT) for stage T1 to T4 prostate cancer between 1997 and 2008 was performed. Treatments were conventional (2-dimensional [2D]) in 61 patients and 3D conformal in 69, with a median target dose of 72 Gy (70-74 Gy). Within 1 week after RT, proctoscopy was performed to detect possible acute endoscopic proctitis (AEP). Acute clinical proctitis (ACP) and late clinical proctitis (LCP) were also evaluated. The median follow-up was 84 months (20-180 months). The influence of AEP and ACP on LCP occurrence was studied using the Cox model controlling for age, dose, prostatectomy, RT technique (2D vs 3D), and hormone therapy.Results: AEP was detected in 15 patients (11.5%) and ACP in 67 (51.5%); in 13 cases (10%) AEP and ACP occurred simultaneously. Thirty-five cases of LCP were recorded. The 5-year probability of developing LCP was highest in patients with AEP and ACP (77%, 95% confidence interval [CI] 53%-94%) and lowest in asymptomatic patients (14%, 95% CI 7%-26%; P