Relationship Between Radiation Therapy and Fecal Incontinence in Patients Treated for Localized Prostate Cancer: Results of the French ICONES Study.

IF 2.6 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Prostate Pub Date : 2025-01-14 DOI:10.1002/pros.24852

Yazid Belkacemi, Gabriele Coraggio, Kamel Debbi, Laura Sirmai, Clemence Hollande, Elise Rambaud, Asma Hadhri, Xie Li, Wissal Hassani, Michael Levy, Dimitri Vordos, Alexandre Ingels, Gokoulakrichenane Loganadane, Alexandre De La Taille

{"title":"Relationship Between Radiation Therapy and Fecal Incontinence in Patients Treated for Localized Prostate Cancer: Results of the French ICONES Study.","authors":"Yazid Belkacemi, Gabriele Coraggio, Kamel Debbi, Laura Sirmai, Clemence Hollande, Elise Rambaud, Asma Hadhri, Xie Li, Wissal Hassani, Michael Levy, Dimitri Vordos, Alexandre Ingels, Gokoulakrichenane Loganadane, Alexandre De La Taille","doi":"10.1002/pros.24852","DOIUrl":null,"url":null,"abstract":"Background: Radiation-induced late fecal incontinence (LFI) is one of the most quality-of-life impairing symptoms in prostate cancer. We aimed to assess the impact of radiotherapy (RT) technique and dose-volume effects on LFI using a robust score.Methods: We identified 409 patients who underwent curative intent using standard fractionated radiation therapy, 190 of them were finally included and analyzed. The severity of LFI was assessed using the Jorge & Wexner score.Results: With a median follow-up of 55 months (range 15-96) months, LFI crude rate was 11.5%. In the multivariate analyses, image-guided radiotherapy (IGRT), rectal maximum dose (Dmax) and anal canal minimum dose (Dmin) were significantly associated with LFI risk. The use of IGRT was associated with lower risk of LFI (p = 0.02); higher rectum Dmax (≥ 68.4 Gy; p = 0.02) and anal canal Dmin (≥ 6.4 Gy; p = 0.04) were associated with increased risk.Conclusion: Our results suggest a significant impact of the total dose delivered to the anorectal volumes and the use of IGRT to spare organs at risk during radiation delivery.","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"e24852"},"PeriodicalIF":2.6000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prostate","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pros.24852","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Radiation-induced late fecal incontinence (LFI) is one of the most quality-of-life impairing symptoms in prostate cancer. We aimed to assess the impact of radiotherapy (RT) technique and dose-volume effects on LFI using a robust score.

Methods: We identified 409 patients who underwent curative intent using standard fractionated radiation therapy, 190 of them were finally included and analyzed. The severity of LFI was assessed using the Jorge & Wexner score.

Results: With a median follow-up of 55 months (range 15-96) months, LFI crude rate was 11.5%. In the multivariate analyses, image-guided radiotherapy (IGRT), rectal maximum dose (Dmax) and anal canal minimum dose (Dmin) were significantly associated with LFI risk. The use of IGRT was associated with lower risk of LFI (p = 0.02); higher rectum Dmax (≥ 68.4 Gy; p = 0.02) and anal canal Dmin (≥ 6.4 Gy; p = 0.04) were associated with increased risk.

Conclusion: Our results suggest a significant impact of the total dose delivered to the anorectal volumes and the use of IGRT to spare organs at risk during radiation delivery.

查看原文本刊更多论文

放射治疗与局限性前列腺癌患者大便失禁的关系：法国ICONES研究的结果

背景：放射诱发的晚期排便失禁（LFI）是前列腺癌中最影响生活质量的症状之一。我们的目的是评估放疗（RT）技术和剂量-体积效应对LFI的影响。方法：我们收集了409例接受标准分次放射治疗的患者，其中190例最终纳入并分析。使用Jorge & Wexner评分评估LFI的严重程度。结果：中位随访55个月（15-96个月），LFI粗率为11.5%。在多因素分析中，影像引导放疗（IGRT）、直肠最大剂量（Dmax）和肛管最小剂量（Dmin）与LFI风险显著相关。使用IGRT与LFI风险降低相关（p = 0.02）；直肠Dmax较高(≥68.4 Gy；p = 0.02)、肛管Dmin(≥6.4 Gy；P = 0.04)与风险增加相关。结论：我们的研究结果表明，在放射输送过程中，总剂量对肛肠体积和IGRT的使用有显著影响，以避免有危险的器官。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Prostate 医学-泌尿学与肾脏学

CiteScore

5.10

自引率

3.60%

发文量

180

审稿时长

1.5 months

期刊介绍： The Prostate is a peer-reviewed journal dedicated to original studies of this organ and the male accessory glands. It serves as an international medium for these studies, presenting comprehensive coverage of clinical, anatomic, embryologic, physiologic, endocrinologic, and biochemical studies.