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Late rectal bleeding after volumetric-modulated arc therapy for localised prostatic cancer

Published online by Cambridge University Press:  26 October 2018

Yutaka Naoi
Affiliation:
Department of Radiation Oncology
Kana Yamada
Affiliation:
Department of Radiation Oncology
Chie Kurokawa
Affiliation:
Department of Radiation Oncology
Hiroaki Kunogi
Affiliation:
Department of Radiation Oncology
Yoshiro Sakamoto
Affiliation:
Department of Urology, Juntendo University Nerima Hospital, Japan
Keisuke Sasai
Affiliation:
Department of Radiation Oncology, Juntendo University, Japan
Corresponding
E-mail address:

Abstract

Aim

Late adverse effects following radiation therapy for prostate cancer involve the urinary and lower gastrointestinal tracts, with continuous rectal bleeding being the most serious issue. We focused on late adverse effects, particularly rectal bleeding after volumetric-modulated arc therapy (VMAT), for patients with locally advanced prostate cancer.

Materials and Methods

Seventy-three patients with localized prostate cancer were treated with radiation therapy using VMAT with an image-guided radiation therapy system. Patient age at the start of irradiation ranged from 54 to 81 years (median, 71 years). The follow-up period ranged from 23 to 87 months (median, 57 months). The prescribed total irradiation dose was 76 Gy in 38 fractions.

Results

Late rectal bleeding was observed in 14 (19%) patients, with nine (12.3%), four (5.5%), and one (1.4%) being classified as grades 1, 2, and 3, respectively. One grade 3 patient with rectal bleeding had severe diabetes and was administered intravenous warfarin for cardiomyopathy.

Findings

VMAT may provide better accuracy and involve fewer time constraints for patients compared with other intensity-modulated radiation therapy (IMRT) methods. The incidence of late rectal bleeding in VMAT is almost equivalent to that of other IMRT methods.

Type
Original Article
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Naoi Y, Yamada K, Kurokawa C, Kunogi H, Sakamoto Y, Sasai K. (2019) Late rectal bleeding after volumetric-modulated arc therapy for localised prostatic cancer. Journal of Radiotherapy in Practice18: 165–168. doi: 10.1017/S1460396918000560

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