Endoscopic scoring of late rectal mucosal damage after conformal radiotherapy for prostatic carcinoma

Wachter, Stefan De; Gerstner, Natascha; Goldner, Gregor; Pötzi, R; Wambersie, André; Pötter, Richard

doi:10.1016/s0167-8140(99)00173-5

Cited by 135 publications

(82 citation statements)

References 21 publications

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“…In the lower dose range, the rectal V 30 Bladder and rectum DVH for all patients are shown in Figure 7. No correlation was observed between the target size and doses to these organs.…”

Section: Incidental Dose To Surrounding Normal Tissuesmentioning

confidence: 99%

Radiotherapy Treatment of Early-Stage Prostate Cancer with IMRT and Protons: A Treatment Planning Comparison

Trofimov

Nguyen

Coen

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

197

163

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Purpose-To compare intensity-modulated photon radiotherapy (IMRT) with 3D-conformal proton therapy (3D-CPT) for early stage prostate cancer, and explore the potential utility of intensitymodulated proton therapy (IMPT).Methods-Ten patients were planned with both 3D-CPT (2 parallel-opposed lateral fields) and IMRT (7 equally spaced coplanar fields). Prescribed dose was 79.2 Gy (or cobalt Gray-equivalent, CGE for protons) to the prostate gland. Dose-volume histograms, dose conformity, and equivalent uniform dose (EUD) were compared. Additionally, plans were optimized for 3D-CPT with nonstandard beam configuration, and for IMPT assuming delivery with beam scanning.Results-At least 98% of the PTV received the prescription dose. IMRT plans yielded better dose conformity to the target, while proton plans achieved higher dose homogeneity, and better sparing of rectum and bladder in the range below 30 Gy/CGE. Bladder volumes receiving over 70 Gy/CGE (V 70 ) were reduced, on average, by 34% with IMRT vs. 3D-CPT, while rectal V 70 were equivalent. EUD from 3D-CPT and IMRT plans were indistinguishable within uncertainties, for both bladder and rectum. With the use of small-angle lateral-oblique fields in 3D-CPT and IMPT, the rectal V 70 was reduced by up to 35% compared to the standard lateral configuration, while the bladder V 70 increased by less than 10%.Conclusions-In the range over 60 Gy/CGE, IMRT achieved significantly better sparing of the bladder, while rectal sparing was similar with 3D-CPT and IMRT. Dose to healthy tissues in the range below 50% of the target prescription was substantially lower with proton therapy.

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“…In the lower dose range, the rectal V 30 Bladder and rectum DVH for all patients are shown in Figure 7. No correlation was observed between the target size and doses to these organs.…”

Section: Incidental Dose To Surrounding Normal Tissuesmentioning

confidence: 99%

Radiotherapy Treatment of Early-Stage Prostate Cancer with IMRT and Protons: A Treatment Planning Comparison

Trofimov

Nguyen

Coen

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

197

163

View full text Add to dashboard Cite

show abstract

“…All the procedures were performed by trained endoscopists (with at least 5 years experience and more than 250 procedures per year). Endoscopic findings were described using the World Organisation of Digestive Endoscopy terminology (11) and evaluated according to the VRS (10). Briefly, the VRS considered presence and severity of five parameters: mucosal congestion, telangiectasia, ulcer, stricture and necrosis.…”

Section: Methodsmentioning

confidence: 99%

Predictive Factors of Late-onset Rectal Mucosal Changes After Radiotherapy of Prostate Cancer

Ippolito

Guido

Macchia³

et al. 2018

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“…Typical endoscopic photos and pathological representative images were collected to present the classical features of CRP. The severity of endoscopic bleeding was scored according to the endoscopic Vienna Rectoscopy Score (VRS) systems (Wachter et al, 2000). Briefly, VRS contains five common endoscopic findings of CRP, i.e., telangiectasia, congested mucosa, ulceration, stricture, and necrosis.…”

Section: Grades and Scoresmentioning

confidence: 99%

Novel and Effective Almagate Enema for Hemorrhagic Chronic Radiation Proctitis and Risk Factors for Fistula Development

Yuan

Ma²,

Zhong³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Radiation proctitis is a common complication after radiotherapy for pelvic malignant tumors. This study was conducted to assess the efficacy of novel almagate enemas in hemorrhagic chronic radiation proctitis (CRP) and evaluate risk factors related to rectal deep ulcer or fistula secondary to CRP. All patients underwent a colonoscopy to confirm the diagnosis of CRP and symptoms were graded. Typical endoscopic and pathological images, risk factors, and quality of life were also recorded. A total of 59 patients were enrolled. Gynecological cancers composed 93.1% of the primary malignancies. Complete or obvious reduction of bleeding was observed in 90% (53/59) patients after almagate enema. The mean score of bleeding improved from 2.17 to 0.83 (P<0.001) after the enemas. The mean response time was 12 days. No adverse effects were found. Moreover, long-term successful rate in controlling bleeding was 69% and the quality of life was dramatically improved (P=0.001). The efficacy was equivalent to rectal sucralfate, but the almagate with its antacid properties acted more rapidly than sucralfate. Furthermore, we firstly found that moderate to severe anemia was the risk factor of CRP patients who developed rectal deep ulcer or fistulas (P= 0.015). We also found abnormal hyaline-like thick wall vessels, which revealed endarteritis obliterans and the fibrosis underlying this disease. These findings indicate that almagate enema is a novel effective, rapid and well-tolerated method for hemorrhagic CRP. Moderate to severe anemia is a risk factor for deep ulceration or fistula.

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Endoscopic scoring of late rectal mucosal damage after conformal radiotherapy for prostatic carcinoma

Cited by 135 publications

References 21 publications

Radiotherapy Treatment of Early-Stage Prostate Cancer with IMRT and Protons: A Treatment Planning Comparison

Radiotherapy Treatment of Early-Stage Prostate Cancer with IMRT and Protons: A Treatment Planning Comparison

Predictive Factors of Late-onset Rectal Mucosal Changes After Radiotherapy of Prostate Cancer

Novel and Effective Almagate Enema for Hemorrhagic Chronic Radiation Proctitis and Risk Factors for Fistula Development

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