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  • [Cancer Res Treat.] Can Anorectal Manometry Findings Predict Subsequent Late Gastrointestinal Radiation Toxicity in Prostate Cancer Patients?

    [Cancer Res Treat.] Can Anorectal Manometry Findings Predict Subsequent Late Gastrointestinal Radiation Toxicity in Prostate Cancer Patients?

    성균관의대/최윤선, 박원*

  • 출처
    Cancer Res Treat.
  • 등재일
    2016 Jan
  • 저널이슈번호
    48(1):297-303.
  • 내용

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    Abstract

    PURPOSE:

    The purpose of this study is to investigate the influence of radiotherapy (RT) on anorectal function and radiation-induced toxicity in patients with prostate cancer.

     

    MATERIALS AND METHODS:

    Fifty-four patients who were treated with RT for prostate cancer (T1c-4N0-1M0) were evaluated. To assess the changes in anorectal function, two consecutive anorectal manometry readings were performed in patients, before and after 4-6 months of RT. Late gastrointestinal (GI) toxicity was defined as symptoms occurring more than 6 months after RT. The median radiation dose was 70.0 Gy (range, 66.0 to 74.0 Gy). Whole pelvis field RT was performed in 16 patients (29.6%). Grade of late radiation toxicity was defined in accordance to the severity of symptoms (Gulliford's scoring system).

     

    RESULTS:

    The median follow-up period was 60 months. Resting anal pressure (p=0.001), squeeze pressure (p < 0.001), and urge to defecate volume (p=0.025) were significantly reduced after RT. Fourteen patients (25.9%) experienced late GI toxicities. Among them, nine (16.7%) showed severe (grade ≥ 2) late toxicities. Elevated resting and squeeze external anal sphincter pressure prior to RT and large urge to defecate volumes after RT were associated with the occurrence of late GI toxicities.

     

    CONCLUSION:

    RT caused symptomatic anorectal dysfunction and resulted in a weakened anal sphincter. Increased urge to defecate volumes after RT were related to late GI toxicities. Elevated resting and squeeze anal sphincter pressure prior to RT rodcan be used to identify patients with an increased risk of late GI toxicities.ConclusionRT caused symptomatic anorectal dysfunction. An increased anal pressure prior to RT and urge to defecate volume after RT was related to an occurrence of late GI toxicities. Application of ARM for screening patients who have an elevated ASP prior to RT could be helpful in identifying patients with an increased risk of late GI toxicities.

     

    Author information

    Choi Y1, Park W2, Rhee PL3.

    1Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea ; Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

    2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

    3Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 

     

     

  • 키워드
    Anorectal manometry; Prostatic neoplasms; Radiation toxicity
  • 연구소개
    본 연구는 전립선암 방사선치료 후 직장의 기능적 변화를 살펴보고, 직장 부작용과 직장 기능의 상관관계를 고찰하여, 직장부작용 발생 가능성을 예측해보고자 하였습니다. 전립선암 환자에게 방사선치료 전 1달, 방사선치료 후 4-6개월째 anorectal manometry를 측정하였습니다. 방사선치료 후 anal sphincter가 약해지는데, 이는 resting anal pressure 저하, squeeze anal pressure 저하, urge to defecate volume 감소가 관찰되었고, 방사선치료 전 resting anal pressure와 spueeze anal pressure가 증가한 경우에 후기 직장 부작용 가능성이 높을 것을 예측할 수 있어, 방사선치료 전 직장의 기능상태에 따라 방사선치료 후 부작용을 예측할 수 있으리라 기대됩니다.
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