Background and purpose: The goals of this study were to determine the rate and risk factors of rectal bleeding (RB) after external beam radiotherapy and vaginal brachytherapy (EBRT + VB), and to compare these data to previously unreported RB rates from PORTEC-2 patients receiving EBRT or VB alone. Materials and methods: Retrospective chart review identified 212 endometrial cancer patients receiving adjuvant EBRT + VB between 2006 and 2013. Patient-reported RB data were also obtained from PORTEC-2 patients randomized to EBRT (n = 166) or VB (n = 182). The two populations were compared using an RB scale of symptom severity. Results: After a median 35 months, 17.9% of EBRT + VB patients (n = 38) experienced any RB with 1.9% (n = 4) having bleeding requiring intervention. Age ≤70 years was the only predictor of RB (OR 2.8; 95% CI 1.1-8.7; p = 0.027). Rates of patient-reported RB after EBRT were similar with 15.0% (n = 25) having any RB and 0.6% (n = 1) having "very much" bleeding. On regression analysis, any EBRT (either EBRT alone or EBRT + VB) increased the risk of RB compared to those who received VB alone (OR 3.0; p = 0.0028; 95% CI 1.4-6.7). The rates of more severe RB were low and did not significantly differ between treatments. Conclusions: Significant RB is rare after radiation. EBRT has higher rates of rectal bleeding than VB. The addition of VB to EBRT does not significantly alter bleeding rates.
- Endometrial cancer
- Rectal bleeding
- Vaginal brachytherapy
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging