Comparing measures of acute bowel toxicity in patients with prostate cancer treated with external beam radiation therapy

Thierry M. Muanza, Paul S. Albert, Sharon Smith, Denise Godette, Nancy Sears Crouse, Theresa Cooley-Zgela, Linda Sciuto, Kevin Camphausen, C. Norman Coleman, Cynthia Ménard

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study strives to compare early measures of bowel toxicity in patients with prostate cancer receiving definitive or adjuvant 3D conformal external beam radiation therapy and concurrent daily endorectal application of amifostine. Methods: Eighteen patients were enrolled in the clinical study with a median follow-up of 12 months. Prescription doses ranged from 66 Gy to 76 Gy with a daily fractionation of 2 Gy. Acute bowel toxicity was measured at baseline, at Weeks 5 and 7 of radiotherapy, and at 1 and 3 months after the completion of therapy. Measures of acute bowel toxicity included the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, Expanded Prostate Cancer Index Composite (EPIC) self-assessment questionnaires, and proctoscopic examinations. Results: The mean EPIC bowel scores changed significantly through the course of therapy and follow-up (p < 0.0001), with a progressive decrease in scores at Weeks 5 and 7 of treatment, a partial recovery at 3 months, and a correlation to the gold standard RTOG grade (p = 0.004). Proctoscopic toxicity scores were low, did not vary over time, and did not correlate with either EPIC or RTOG scores. Conclusion: The EPIC questionnaire measurements are most sensitive to changes in acute bowel toxicity through a course of radiotherapy and correlate with RTOG acute toxicity scores. Endoscopic examination of the rectal mucosa at the end and immediate follow-up of a course of therapy does not seem to be informative or reproducible between observers in the acute setting.

Original languageEnglish (US)
Pages (from-to)1316-1321
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume62
Issue number5
DOIs
StatePublished - Aug 1 2005

Keywords

  • Bowel toxicity
  • Endoscopy
  • Prostate cancer
  • Radiation

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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