Fondazione di Ricerca e Cura Giovanni Paolo II, Università Cattolica del S. Cuore, Campobasso, Italy.
Radiother Oncol. 2012 Jul;104(1):103-8. doi: 10.1016/j.radonc.2012.05.010. Epub 2012 Jun 23.
Late rectal complications are assessed according to different scoring systems. Endoscopy can provide a more sensitive estimation of early radiation damage. The aim of this paper is to investigate the correlation between dosimetric parameters and rectal mucosal changes after radiotherapy (RT).
Patients with prostate adenocarcinoma treated with curative or adjuvant RT underwent endoscopy 1 year after RT. Receiver operating characteristics (ROC) analysis was performed to analyze the predictive capability of the dosimetric variables in determining mucosal changes classified by Vienna Rectoscopy Score (VRS).
The best dosimetric predictors of grade ≥2 telangiectasia were rectal (r) V(60 Gy) (p=0.014), rV(70 Gy) (p=0.017) and rD(mean) (p=0.018). Similar results were obtained for grade ≥2 VRS. The set of rV(60 Gy)<34.4%, rV(70 Gy)<16.7% and rD(mean)<57.5 Gy was associated with a decreased risk of grade ≥2 telangiectasia and VRS.
rV(60 Gy), rV(70 Gy) and rD(mean) were the strongest predictors of rectal mucosal alterations. In-depth analysis is required to correlate each mucosal alteration with late rectal toxicity in order to suggest early proctoscopy as surrogate end-point for rectal late toxicity in studies aimed at reducing this important complication.
晚期直肠并发症根据不同的评分系统进行评估。内镜检查可以更敏感地估计早期辐射损伤。本文旨在探讨放疗后直肠黏膜变化与剂量学参数之间的相关性。
接受根治性或辅助性放疗的前列腺腺癌患者在放疗后 1 年进行内镜检查。采用受试者工作特征（ROC）分析，分析剂量学变量在确定维也纳直肠镜评分（VRS）分类的黏膜变化中的预测能力。
预测≥2 级毛细血管扩张的最佳剂量学指标为直肠（r）V（60Gy）（p=0.014）、rV（70Gy）（p=0.017）和 rD（mean）（p=0.018）。对于≥2 级 VRS，也得到了类似的结果。rV（60Gy）<34.4%、rV（70Gy）<16.7%和 rD（mean）<57.5Gy 的 rV（60Gy）<34.4%、rV（70Gy）<16.7%和 rD（mean）<57.5Gy 与发生≥2 级毛细血管扩张和 VRS 的风险降低相关。
rV（60Gy）、rV（70Gy）和 rD（mean）是直肠黏膜改变的最强预测因子。为了将每种黏膜改变与晚期直肠毒性相关联，以便在旨在减少这一重要并发症的研究中建议早期直肠镜检查作为直肠晚期毒性的替代终点，需要进行深入分析。
