Systematic Review of the Relationship between Acute and Late Gastrointestinal Toxicity after Radiotherapy for Prostate Cancer

Abstract

A small but meaningful percentage of men who are treated with external beam radiation therapy for prostate cancer will develop late gastrointestinal toxicity. While numerous strategies to prevent gastrointestinal injury have been studied, clinical trials concentrating on late toxicity have been difficult to carry out. Identification of subjects at high risk for late gastrointestinal injury could allow toxicity prevention trials to be performed using reasonable sample sizes. Acute radiation therapy toxicity has been shown to predict late toxicity in several organ systems. Late toxicities may occur as a consequential effect of acute injury. In this systematic review of published reports, we found that late gastrointestinal toxicity following prostate radiotherapy seems to be statistically and potentially causally related to acute gastrointestinal morbidity as a consequential effect. We submit that acute gastrointestinal toxicity may be used to identify at-risk patients who may benefit from additional attention for medical interventions and close follow-up to prevent late toxicity. Acute gastrointestinal toxicity could also be explored as a surrogate endpoint for late effects in prospective trials.

Effects of a nutrition intervention on acute and late bowel symptoms and health-related quality of life up to 24 months post radiotherapy in patients with prostate cancer: a multicentre randomised controlled trial

“…Acute symptoms such as diarrhoea, abdominal pain and urgency can occur during the treatment period and may subside after RT completion [1,4]. In addition, severe acute symptoms increase the risk of late bowel symptoms [5]. Late side effects, i.e.…”

Older Age, Early Symptoms and Physical Function are Associated with the Severity of Late Symptom Clusters for Men Undergoing Radiotherapy for Prostate Cancer

“…This is because both baseline and acute symptoms have been found to be a precursor of late symptoms. This has been termed as consequential late effects [18] , [19] . In addition, treatment factors (ADT, radiotherapy dose or fractionation) have been found to directly affect acute and late symptoms [20] .…”

Prosztatarákban szenvedő betegek definitív ellátásának tanulságai és modern stratégiái

“…A gyakorlatban a legtöbb szövődmény 1-es, illetve 2-es fokozatú. A heveny és zavaró szövődmények előrevetíthetik a késő szövődmények veszélyét, ezért már ezek jelentkezésekor érdemes a beteg besugárzási tervének ellenőrzése, szükség esetén esetleges korrekciója [34,35]. Az ismertetett esetekben mindkét betegnél grade 2-es akut cystitises mellékhatások jelentkeztek már a besugárzás 2/3-ánál.…”