Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding
Rectal bleeding after hypofractionated radiotherapy for prostate cancer: Correlation between clinical and dosimetric parameters and the incidence of grade 2 or worse rectal bleeding
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DOI：
10.1016/j.ijrobp.2004.07.695
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发表时间：
2004-11-15
影响因子：
7
通讯作者：
Niibe, H
中科院分区：
文献类型：
--
作者：
Akimoto, T;Muramatsu, H;Niibe, H
目的：研究前列腺癌大剂量低分次放疗（RT）后直肠出血的发生率和严重程度，并探讨影响2级及更严重直肠出血发生率的因素。
方法和材料：分析了1999年至2002年间52例接受外照射放疗治疗局限性前列腺癌患者的数据。所有患者均接受了低分次外照射放疗，总剂量为69Gy，每次3Gy，每周3次。通过单因素和多因素分析来分析影响2级及更严重晚期直肠出血发生率的临床和剂量学因素。评估了接受30%、50%、80%和90%规定辐射剂量的直肠总体积百分比（分别为V - 30、V - 50、V - 80和V - 90）对直肠出血发生率的影响。
结果：52例患者中，13例（25%）发生了2级及更严重的直肠出血。1例因直肠出血需要激光凝固和输血治疗的患者被归类为3级直肠出血。发生2级及更严重直肠出血的中位时间为11个月。单因素分析结果显示，糖尿病病史（p < 0.001）以及V - 30≥60%、V - 50≥40%（p < 0.05）、V - 80≥25%和V - 90≥15%（p < 0.001）是发生2级及更严重直肠出血的有统计学意义的危险因素。多因素分析结果显示，糖尿病病史是前列腺癌低分次放疗后发生直肠出血最有统计学意义的危险因素（p < 0.05）。
结论：糖尿病病史是大剂量低分次放疗后发生2级及更严重直肠出血最有统计学意义的危险因素，尽管剂量学因素也与直肠出血风险密切相关。（C）2004爱思唯尔公司
Purpose: To investigate the incidence and severity of rectal bleeding after high-dose hypofractionated radiotherapy (RT) for prostate cancer, and to explore the factors affecting the incidence of Grade 2 or worse rectal bleeding.Methods and Materials: The data of 52 patients who had been treated by external beam RT for localized prostate cancer between 1999 and 2002 were analyzed. All the patients had received hypofractionated external beam RT to a total dose of 69 Gy in 3-Gy fractions, three fractions weekly. The clinical and dosimetric factors affecting the incidence of Grade 2 or worse late rectal bleeding were analyzed by univariate and multivariate analyses. The effect of the percentage of the whole rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose (V-30, V-50, V-80, and V90, respectively) on the incidence of rectal bleeding was evaluated.Results: Of the 52 patients, 13 (25%) developed Grade 2 or worse rectal bleeding. One patient who needed laser coagulation and blood transfusion for the treatment of rectal bleeding was classified as having Grade 3 rectal bleeding. The median time to the development of Grade 2 or worse rectal bleeding was 11 months. The results of the univariate analysis revealed that the presence of a history of diabetes mellitus (p < 0.001), and V-30 greater than or equal to 60%, V-50 greater than or equal to 40% (p < 0.05), V-80 greater than or equal to 25%, and V-90 greater than or equal to 15% p < 0.001) were statistically significant risk factors for the occurrence of Grade 2 or worse rectal bleeding. The results of the multivariate analysis revealed that a history of diabetes mellitus was the most statistically significant risk factor for the occurrence of rectal bleeding after hypofractionated RT for prostate cancer (p < 0.05).Conclusion: A history of diabetes mellitus was the most statistically significant risk factor for the occurrence of Grade 2 or worse rectal bleeding after high-dose hypofractionated RT, although dosimetric factors were also closely associated with the risk of rectal bleeding. (C) 2004 Elsevier Inc.