Patient-related risk factors for late rectal bleeding after hypofractionated radiotherapy for localized prostate cancer: a single-center retrospective study

Autor: Tae Gyu Kim, Byungdo Park, Yun Gyu Song, Hyoun Wook Lee, Tae Hee Oh, Dong-Soo Ryu, Seung Chan Jeong, Daehyeon Cho, Jieun Oh, Kwang Min Kim, Jung Won Lee, Hyoun Soo Lee, Sung Min Kong, Jun Young Kim, Haeyoung Kim
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Radiation Oncology, Vol 17, Iss 1, Pp 1-11 (2022)
Druh dokumentu: article
ISSN: 1748-717X
DOI: 10.1186/s13014-022-01998-4
Popis: Abstract Background Several studies have reported patient-related risk factors for late rectal bleeding following conventionally fractionated radiotherapy for prostate cancer. We investigated patient-related risk factors for late rectal bleeding after hypofractionated radiotherapy. Methods A total of 231 patients with local or locally advanced prostate cancer treated with hypofractionated radiotherapy (70 or 67.2 Gy in 28 fractions) were evaluated retrospectively. All patients received intensity-modulated radiotherapy with daily image guidance. The relationships between late rectal bleeding and risk factors like diabetes, hypertension, cirrhosis, and anticoagulant use were analyzed. Results During a median follow-up of 23 months, the crude rates of grade ≥ 1, grade ≥ 2, and grade ≥ 3 late rectal bleeding were 23.8%, 16.9%, and 9.5%, respectively. Cirrhosis and anticoagulant use predicted an increased risk of grade ≥ 3 rectal bleeding in multivariable analyses (hazard ratio [HR] 14.37, 95% confidence interval [CI] 3.09–66.87, P = 0.001, and HR 2.93, 95% CI 1.14–7.55, P = 0.026, respectively). The non-anticoagulant group had a significantly superior 5-year freedom from grade ≥ 3 bleeding compared to the anticoagulant group in a propensity-weighted log-rank analysis (88.0% vs. 76.7%, P = 0.041). A receiver operating characteristic curve analysis revealed that rectal bleeding was minimized in the anticoagulant group if the equivalent dose at fractionation of 2 Gy (EQD2) V77 Gy of the rectum was
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