Is Radiotherapy of Benefit for Men With Prostate Cancer and Inflammatory Bowel Disease?
Posted: Tuesday, August 24, 2021
Jonathan Haas, MD, of Perlmutter Cancer Center at New York University Langone Hospital, New York, and colleagues reviewed clinical outcomes of patients with underlying inflammatory bowel disease who underwent stereotactic body radiation therapy for prostate cancer in Radiation Oncology. Although these investigators reported low rates of gastrointestinal toxicity with no significant effect on oncologic outcome with this treatment in these men, they advise caution when subjecting patients with inflammatory bowel disease to therapeutic radiation.
From a cohort of 4,245 patients treated with stereotactic body radiation therapy for prostate cancer, 31 were identified to have underlying inflammatory bowel disease. Participants were treated using a robotic radiosurgical platform with prostate motion; intrarectal amifostine was administered to all patients to reduce radiation-related gastrointestinal toxicity.
More than half of individuals (58%) with inflammatory bowel disease had an excellent documented Eastern Cooperative Oncology Group performance status, and the age of most patients ranged from 60 to 70 years. The most common subtype of inflammatory bowel disease was ulcerative colitis (n = 18), followed by Crohn’s disease (n = 11). Additionally, more than three-quarters of patients (77%) received prior medical treatment for their inflammatory bowel disease.
A large majority of patients (84%) were administered 3,500 cGy in five fractions; three participants were treated with 3,625 cGy, and two were given a prostate and seminal vesicle boost of 2,100 cGy and 1,950 cGy, respectively, in three fractions after nodal irradiation (4,500 cGy in 25 fractions). At the median follow-up of 22 months, no participants were found to have any biochemical relapse.
High-grade acute and late gastrointestinal toxicities were observed in only one patient, with a median time to toxicity of 22 months. Grade 2 to 3 proctitis and low-grade hemorrhoids affected three patients each; both side effects were observed in individuals who underwent a total dose of 3,500 cGy in five fractions.
Disclosure: For full disclosures of the study authors, visit ro-journal.biomedcentral.com.
