Dissertation committee:
Γεώργιος Μπάμιας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Συρίγος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Στεργίου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Παπαθεοδωρίδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Βλαχογιαννάκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Καραμανώλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γαρυφαλλιά Πουλάκου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Purpose: Previous randomized clinical trials have shown that moderate hypofractionation has a non-inferior or even superior efficacy to conventionally fractionated external beam radiation therapy (EBRT) in low and intermediate-risk prostate cancer. We herein aimed to evaluate the acute and late gastrointestinal (Gl) toxicity profile of hypofractionated radiotherapy (HRT) in a real-world setting.
Methods: Patients with intermediate-risk prostate adenocarcinoma eligible to receive HRT were prospectively enrolled. All patients were submitted to rectoscopy after completion of HRT, every three months after radiotherapy for the first year and every six months for the second year. Toxicity events were classified as acute, when presenting during radiotherapy or within the first three months following its completion, and as late when appearing three months to three years post-HRT.
Results: Twenty prostate cancer patients participated in this study and received 22 sessions of HRT (5 sessions a week; 2.75Gy per session) and an overall dose of 60,5 Gy. None of our patients developed acute Gl toxicity; late Gl toxicity (RTOG/EORTC grade 3 rectal bleeding) was observed in 1 patient only (1/20, 5%), at 6 and 12 months post-HRT. No rectal mucosa damage was observed on follow-up rectoscopy in the acute phase in any of our patients; five patients (5/20, 25%) developed late telangiectasias. Vienna retroscopy score (VRS) was 1 in 4/5 patients (80%) and 2 in 1/5 (20%).
Conclusion: Minimal radiation-induced rectal mucosal damage was observed in our patient population, and only as a late event, thus further attesting to the safety of HRT in this setting.
