Reduced late rectal mucosal changes after prostate three-dimensional conformal radiotherapy with endorectal balloon as observed in repeated endoscopy.
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Publication year
2007Source
International Journal of Radiation Oncology, Biology, Physics, 67, 3, (2007), pp. 799-811ISSN
Publication type
Article / Letter to editor
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Organization
Radiation Oncology
Gastroenterology
Journal title
International Journal of Radiation Oncology, Biology, Physics
Volume
vol. 67
Issue
iss. 3
Page start
p. 799
Page end
p. 811
Subject
N4i 1: Pathogenesis and modulation of inflammation; ONCOL 3: Translational research; UMCN 1.1: Functional Imaging; UMCN 5.5: Nutrition and HealthAbstract
PURPOSE: The aim of this study was to investigate prospectively the rectal wall (Rwall) spatial dose distribution, toxicity, and mucosal changes after prostate cancer radiotherapy with or without an endorectal balloon (ERB). METHODS AND MATERIALS: A total of 24 patients with ERB and 24 without ERB (No-ERB) were treated with three-dimensional conformal radiotherapy (3D-CRT) to a dose of 67.5 Gy. The Rwall was divided into 16 mucosal areas and Rwall dose surface maps were constructed. After 3 months, 6 months, 1 year, and 2 years a rectosigmoidoscopy was performed, and each mucosal area was scored on telangiectasia, congestion, ulceration, stricture, and necrosis. Late rectal toxicity was correlated with the endoscopic findings. RESULTS: The ERB significantly reduced the Rwall volume exposed to doses >40 Gy. Late rectal toxicity (grade >or=1, including excess of bowel movements and slight rectal discharge) was reduced significantly in the ERB group. A total of 146 endoscopies and 2,336 mucosal areas were analyzed. Telangiectases were most frequently seen and appeared after 6 months. At 1 and 2 years, significantly less high-grade telangiectasia (T 2-3) was observed in the ERB group at the lateral and posterior part of the Rwall. In mucosal areas exposed to doses >40 Gy, less high-grade telangiectases (T 2-3) were seen in the ERB group compared with the No-ERB group. CONCLUSIONS: An ERB reduced the Rwall volume exposed to doses >40 Gy, resulting in reduction of late rectal mucosal changes and reduced late rectal toxicity. Although further analysis is needed, these data suggest an ERB-induced increased tolerance for late Rwall damage.
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- Academic publications [238441]
- Electronic publications [122537]
- Faculty of Medical Sciences [90373]
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