Late radiation damage in prostate cancer patients treated by high dose external radiotherapy in relation to rectal dose.

A retrospective analysis of the incidence of radiation proctitis was performed in 154 patients with carcinoma of the prostate treated with external radiotherapy assisted by CT-scan planning from 1983 to 1985. An attempt was made to assess a dose-response relationship for proctitis. Multivariate Cox regression analysis showed that previous bowel disease or surgery, anterior rectal dose, and average rectal dose contributed to a higher risk of proctitis.

Carcinoma of the urinary bladder category T2,3NXM0 treated by 40 Gy external irradiation followed by cesium137 implant at reduced dose (50%).

Forty-eight bladder cancers T2NXM0 with bad prognostic factors and 42 T3NXM0 growths, suitable for interstitial treatment, were submitted to 40 Gy external irradiation immediately followed by Cae137 Implant at "reduced dose". Intercurrent death corrected 5-year survival for both groups was about 80%. The influence of previously identified bad prognosticators (more than one TUR, WHO grade 3, 4, vascular invasion in the biopsy specimen, pathological IVP) was nearly eradicated.

Late radiation injuries of the gastrointestinal tract in the H2 and H5 EORTC Hodgkin's disease trials: emphasis on the role of exploratory laparotomy and fractionation.

Out of 516 patients who entered in the two successive EORTC trials H2 and H5 for supra-diaphragmatic stages I and II Hodgkin's disease (HD), and who received an infra-diaphragmatic irradiation, 36 (7%) developed late radiation injuries of the gastrointestinal tract (GIT). Twenty-five patients presented with ulcers (stomach or duodenum), 2 with severe gastritis, 6 with small bowel obstruction or perforation and 3 patients had both an ulcer and bowel obstruction. A previous laparotomy played an important role.