Japanese Journal of Clinical Oncology 30:225-229 (2000)
© 2000 Foundation for Promotion of Cancer Research
The Relationship Between Technical Parameters of External Beam Radiation Therapy and Complications for Localized Prostate Cancer
Departments of 1Radiology and 3Urology, Hokkaido University School of Medicine, Sapporo, 2Department of Radiology, Obihiro Kosei Hospital, Obihiro, 4Takayama Urological Hospital, Obihiro and 5Department of Urology, Otaru Municipal Hospital, Otaru, Japan
Background: This study was performed to review retrospectively the clinical course of chronic rectal bleeding as a complication of external beam radiation therapy for localized prostate cancer and to analyze the relationship between technical parameters of radiation therapy and the complications.
Methods: Seventy-one patients with stages A2, B and C were treated with local-field radiotherapy (total dose 52.5–66 Gy, daily dose 2.0–3.28 Gy, field area 30–81 cm2, number of fields 3–15 ports, planning simulations X-ray or CT-based) between 1989 and 1998 at three institutions. The protocols were consistent during this same period at these institutions.
Results: Multivariate analysis revealed pretreatment PSA and Gleason sum to be statistically significant predictors of 5 year prostatic specific antigen (PSA) relapse-free rates in a median follow-up period of 42 months (range 12–119 months). The significant risk factors for higher grading of acute morbidity were a biological equivalent dose, 
/ß = 10(BED10) 
65 Gy, dose per fraction 3.0 Gy, field area 42 cm2, fewer ports and X-ray planning simulation. However, no parameter was associated with higher grading of late morbidity. Eleven patients (15.4%) experienced a late GI complication: grade 1 (4.2%), grade 2 (9.8%), grade 3 (1.4%). The median time to occurrence of rectal bleeding was 12 months after radiotherapy and the mean duration of morbidity was 11 months.
Conclusions: Higher total dose and dose per fraction, larger field area, fewer ports and X-ray simulation increased the grades of acute morbidity. A majority of chronic rectal bleedings were transient and responded to conservative treatment.
+ For reprints and all correspondence: Kei Kitamura, Department of Radiology, Hokkaido University School of Medicine, North-15, West-7, Kita-ku, Sapporo 060-8638, Japan. E-mail: ktmr@radi.med.hokudai.ac.jp
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  A. Takahashi, M. Yanase, N. Masumori, H. Sasamura, T. Oda, T. Tanaka, N. Itoh, T. Tsukamoto, A. Oouchi, M. Hareyama, et al. External Beam Radiation Monotherapy for Localized or Locally Advanced Prostate Cancer Jpn. J. Clin. Oncol., February 1, 2003; 33(2): 73 - 77. [Abstract] [Full Text] [PDF]
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