Rectal bleeding after radiation therapy for endometrial cancer

Devarati Mitra, Remi Nout, Paul J. Catalano, Carien Creutzberg, Nicole Cimbak, Larissa Lee, Akila N. Viswanathan

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)240-245
Number of pages6
JournalRadiotherapy and Oncology
Issue number2
StatePublished - May 1 2015
Externally publishedYes


  • Endometrial cancer
  • Rectal bleeding
  • Vaginal brachytherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging


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