Affordable Access

deepdyve-link deepdyve-link
Publisher Website

Late rectal toxicity after low-dose-rate brachytherapy: incidence, predictors, and management of side effects.

Authors
  • Kishan, Amar U
  • Kupelian, Patrick A
Type
Published Article
Journal
Brachytherapy
Publisher
Elsevier
Publication Date
Jan 01, 2015
Volume
14
Issue
2
Pages
148–159
Identifiers
DOI: 10.1016/j.brachy.2014.11.005
PMID: 25516492
Source
Medline
Keywords
License
Unknown

Abstract

As clinical outcomes for patients with clinically localized prostate cancer continue to improve, patients and physicians are increasing making treatment decisions based on concerns regarding long-term morbidity. A primary concern is late radiation proctitis, a clinical entity embodied by various signs and symptoms, ranging from diarrhea to rectal fistulas. Here, we present a comprehensive literature review examining the clinical manifestations and pathophysiology of late radiation proctitis after low-dose-rate brachytherapy (BT), as well as its incidence and predictors. The long-term risks of rectal bleeding after BT are on the order of 5-7%, whereas the risks of severe ulceration or fistula are on the order of 0.6%. The most robust predictor appears to be the volume of rectum receiving the prescription dose. In certain situations (e.g., salvage setting, for patients with increased radiosensitivity, and following aggressive biopsy after BT), the risk of these severe toxicities may be increased by up to 10-fold. A variety of excellent management options exist for rectal bleeding, with endoscopic methods being the most commonly used.

Report this publication

Statistics

Seen <100 times