Rectal toxicity and rectal dosimetry in low-dose-rate 125I permanent prostate implants: A long-term study in 1006 patients

Keyes, Mira; Spadinger, Ingrid; Liu, Mitchell; Pickles, Tom; Pai, Howard; Hayden, Alix; Moravan, Veronika; Halperin, Ross; McKenzie, Michael; Kwan, Winkle; Agranovic, Alexander; Lapointe, Vince; Morris, William

doi:10.1016/j.brachy.2011.05.007

Cited by 64 publications

(42 citation statements)

References 38 publications

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“…Direct anal injury, resulting in stenosis, tenesmus, and pain can also occur. Significant bleeding occurring in approximately 5e7% of patients treated with BTand more severe sequelae, such as significant ulcers or fistulas, occur much less frequently, on the order of 0.5% (see Table 1 and accompanying discussion later) (10,12).…”

Section: Clinical Manifestations and Pathophysiologymentioning

confidence: 99%

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

Kishan

Kupelian

2015

Brachytherapy

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Section: Clinical Manifestations and Pathophysiologymentioning

confidence: 99%

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

Kishan

Kupelian

2015

Brachytherapy

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“…2,3 For patients also treated with EBRT, the incidence of high-grade toxicity can be higher than with either therapy alone. 4,5 Biopsies of the rectum following radiation is a known risk factor for fistula formation, which this patient did not have.…”

Section: Discussionmentioning

confidence: 99%

Penile necrosis requiring penectomy complicating recto-urethral fistula post prostate cancer external beam radiation and brachytherapy

Kinahan

Pai²,

Martens³

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(1-2):e57-9. http://dx.doi.org/10.5489/cuaj.1112 Published online January 14, 2014. AbstractRadiation therapy is a well-recognized treatment for unfavourable risk localized prostate cancer. Radiation induced recto-urethral fistulae are known rare complications particularly from brachytherapy. We report a case of a recto-urethral fistula 7 years postexternal beam radiation and I-125 brachytherapy, which was complicated by a severe polymicrobial soft tissue infection. This infection required penectomy and pelvic exenteration with diverting colostomy, Indiana pouch urinary diversion and gracilis myocutaneuos flap closure of the perineum.

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“…However, a safe rectal radiation dose cutoff is difficult to establish as most studies find marked rectal radiation dose overlap between symptomatic and asymptomatic patients, and some patients with exceedingly high rectal doses develop no complications [6][7][8] , suggesting individual susceptibility factors. Some patient characteristics that have been associated with increased risk of late radiation toxicity include vascular disease, diabetes, connective tissue disease, inflammatory bowel disease, HIV infection, smoking, and genetic variations [5] .…”

Section: Discussionmentioning

confidence: 99%

Pelvic Catastrophe after Elastic Band Ligation in an Irradiated Rectum

Pita¹,

Bastos²,

Dinis-Ribeiro³

2017

GE Port J Gastroenterol

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Chronic radiation proctopathy is a frequent complication after both pelvic external radiation therapy and brachytherapy and most commonly presents as rectal bleeding. Deep rectal ulcers and fistulae are much rarer and more clinically challenging consequences. We present the case of a 72-year-old male with a history of prostate adenocarcinoma treated with brachytherapy, who was referred to our institution due to a deep painful rectal ulcer refractory to medical treatment. The ulcer presented shortly after a haemorrhoid elastic band ligation and progressed to rectourethral fistulisation despite both faecal and urinary diversion. Our case demonstrates the importance of favouring a conservative approach when dealing with an irradiated rectum.

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Rectal toxicity and rectal dosimetry in low-dose-rate 125I permanent prostate implants: A long-term study in 1006 patients

Cited by 64 publications

References 38 publications

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

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

Penile necrosis requiring penectomy complicating recto-urethral fistula post prostate cancer external beam radiation and brachytherapy

Pelvic Catastrophe after Elastic Band Ligation in an Irradiated Rectum

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