Predictors of radiation-induced gastrointestinal morbidity: a prospective, longitudinal study following radiotherapy for carcinoma of the prostate

Yeoh, Eric K., Krol, Robin, Dhillon, Varinderpal S., Botten, Rochelle, Di Matteo, Addolorata, Butters, Julie, Brock, Aleisha R., Esterman, Adrian, Salisbury, Carolyn, and Fenech, Michael (2016) Predictors of radiation-induced gastrointestinal morbidity: a prospective, longitudinal study following radiotherapy for carcinoma of the prostate. Acta Oncologica, 55 (5). pp. 604-610.

[img] PDF (Published Version) - Published Version
Restricted to Repository staff only

View at Publisher Website: http://dx.doi.org/10.3109/0284186X.2015....
 
9
8


Abstract

Background: Chronic gastrointestinal (GI) morbidity occurs in ≥50% of patients after external beam radiotherapy (EBRT) for carcinoma of prostate (CaP). This prospective, longitudinal study examines which baseline measurements of: 1) homocysteine and micronutrients in plasma; 2) chromosome damage/misrepair biomarkers; and 3) anal and rectal dose volume metrics predict GI morbidity after EBRT.

Patients and methods: In total, 106 patients with CaP had evaluations of GI symptoms (modified LENT-SOMA questionnaires) before EBRT and at one month, one, two and three years after its completion. Other variables measured before EBRT were: 1) plasma concentrations of homocysteine and micronutrients including caroteinoids and selenium; 2) chromosome damage/DNA misrepair (micronuclei/nucleoplasmic bridge) indices; and 3) mean anal and rectal wall doses and volumes of anal and rectal walls receiving ≥40 Gy and ≥60 Gy. Univariate and multivariate analyzes examined the relationships among: 1) plasma levels of homocysteine and micronutrients; 2) indices of chromosome damage/DNA misrepair; and 3) mean anal and rectal wall doses and volumes of anal and rectal walls receiving ≥40 Gy and ≥60 Gy and total GI symptom scores from one month to three years after EBRT.

Results: Increased frequency and urgency of defecation, rectal mucous discharge and bleeding after EBRT resulted in sustained rises in total GI symptom scores above baseline at three years. On univariate analysis, total GI symptom scores were significantly associated with: 1) plasma selenium and α tocopherol; 2) micronuclei indices of DNA damage; 3) mean anal and rectal wall doses; and 4) volumes of anal and rectal wall receiving ≥40 Gy and ≥60 Gy (p = 0.08–<0.001). On multivariate analysis, only volume of anal wall receiving ≥40 Gy was significant for increased GI symptoms after EBRT (p < 0.001).

Conclusion: The volume of anal wall receiving ≥40 Gy predicts chronic GI morbidity after EBRT for CaP.

Item ID: 46171
Item Type: Article (Research - C1)
ISSN: 1651-226X
Funders: Royal Adelaide Hospital, CRC for Diagnostics
Date Deposited: 01 Feb 2017 03:23
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110307 Gastroenterology and Hepatology @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1112 Oncology and Carcinogenesis > 111208 Radiation Therapy @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 33%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 50%
Downloads: Total: 8
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page