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Late rectal function after prostate brachytherapy.

Gregory S Merrick1, Wayne M Butler, Kent E Wallner

  • 1Schiffler Cancer Center, Wheeling Hospital, and Wheeling Jesuit University, Wheeling, WV 26003-6300, USA. SchifflerCancerCenter@whellinghospital.com

International Journal of Radiation Oncology, Biology, Physics
|August 12, 2003
PubMed
Summary
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Permanent prostate brachytherapy generally results in minor bowel changes, with most patients reporting no worsening of rectal function over time. Quality of life scores for bowel function showed slight improvement in this study.

Area of Science:

  • Oncology
  • Radiation Oncology
  • Urology

Background:

  • Permanent prostate brachytherapy is a common treatment for localized prostate cancer.
  • Assessing long-term rectal function after brachytherapy is crucial for patient quality of life.

Purpose of the Study:

  • To evaluate the long-term effects of permanent prostate brachytherapy on patient-reported rectal function.
  • To identify clinical, treatment, and dosimetric factors associated with late rectal dysfunction.

Main Methods:

  • A cohort of 189 patients treated with permanent prostate brachytherapy completed the Rectal Function Assessment Score (R-FAS) questionnaire.
  • Follow-up averaged 66.3 months, with analysis of various clinical and dosimetric parameters.
  • The R-FAS, with higher scores indicating poorer function, was used to assess outcomes.

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Main Results:

  • The overall R-FAS score was 3.92, indicating mild bowel dysfunction.
  • Pre-implant bowel movement frequency, tobacco use, and median rectal dose correlated with R-FAS scores.
  • Only 12% of patients reported worsened bowel function; supplemental external beam radiation therapy (EBRT) negatively impacted quality of life.

Conclusions:

  • Permanent prostate brachytherapy leads to minimal long-term rectal changes for most patients.
  • The majority of patients do not experience significant deterioration in bowel function post-treatment.
  • Rectal function, as measured by R-FAS, shows a trend towards improvement over time.