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Medical Journal of Islamic Republic of Iran، جلد ۳۵، شماره ۱، صفحات ۵۳۵-۵۴۱
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عنوان انگلیسی Clinical effects of rectal retractor application in prostate cancer radiotherapy
چکیده انگلیسی مقاله Background: Radiation-induced rectal toxicities remain as a major risk during prostate radiotherapy. One approach to the reduction of rectal radiation dose is to physically increase the distance between the rectal wall and prostate. Therefore, the aim of this study was to evaluate whether the application of the rectal retractor (RR) can reduce rectal dose and toxicity in prostate cancer 3-dimensional conformal radiotherapy (3D-CRT).    Methods: Overall, 36 patients with localized prostate cancer were randomized into the 2 groups, 18 patients with RR in-place and 18 without RR. All patients underwent planning computed tomography (CT). Patients were treated with 70 Gy in 35 fractions of 3D-CRT. In the RR group, RR was used during cone-down 20 treatment fractions. Acute and late gastrointestinal (GI) toxicities were assessed using EORTC/RTOG scoring system weekly during radiotherapy, 3, and 12 months after treatment. Device-related events were recorded according to CTCAE version 4.0. Patient characteristics, cancer differences, and dosimetric data for the RR and non-RR groups were compared using a Man-Whitney U test for continuous variables, and Fisher exact test for categorical data. The EORTC/RTOG scores for the 2 groups were compared using Fisher exact test. A P value < 0.05 was considered statistically significant.    Results: A RR significantly reduced mean dose (Dmean) to the rectum as well as rectal volume receiving 50% to 95% (V50-95%) of prescribed dose. The absolute reduction of rectal Dmean was 10.3 Gy. There was no statistically significant difference in acute GI toxicity between groups during treatment or at 3 months. At 12 months, 2 patients in the RR group and 9 in the control group experienced late grade ≥ 1 GI toxicity (p=0.027). No patients in the RR group reported late grade ≥ 2 GI toxicity, whereas 3 patients in the control group experienced late grade 2 GI toxicity. In the RR group, 6 patients reported grade 1 rectal discomfort and pain according to CTCAE version 4.0.    Conclusion: The application of the RR showed a significant rectum sparing effect, resulting in substantially reducing late GI toxicity.  
کلیدواژه‌های انگلیسی مقاله Prostate cancer, Radiotherapy, Rectal toxicity, Rectal retractor
نویسندگان مقاله | Amir Mohammad Arefpour
Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran


| Mahshid Abbasi
Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran


| Seied Rabi Mahdavi
Department of Medical Physics, School of Medicine, & Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran


| Mahdiyeh Shafieesabet
Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran


| Pedram Fadavi
Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
نشانی اینترنتی http://mjiri.iums.ac.ir/browse.php?a_code=A-10-6316-1&slc_lang=en&sid=1
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کد مقاله (doi)
زبان مقاله منتشر شده en
موضوعات مقاله منتشر شده Oncology
نوع مقاله منتشر شده Original Research: Clinical Science
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