ESTRO 2024 - Abstract Book

S2601

Clinical - Urology

ESTRO 2024

Fifty-four (17%) patients had T1 disease, 60 (19%) had T2 disease, while 121 (38%) and 71 (23%) had T3a- and T3b disease, respectively. Twenty-eight (9%) patients did not receive ADT, 39 (12%) patients received ADT for 6 months and 244 (77%) received ADT for 36 months. At BL the prevalence rates of patients reporting RB “About half the time”, “Usually” and “Always” were 0%, 0.4% (CI:0.01-2.3) and 0.4% (CI:0.01-2.3), respectively. At 24 months of follow-up (n=170) 15% (CI:10-22) of patients reported RB “About half the time”, 4.7% (CI:2 - 9) “Usually” and 0.6% (CI:0.0 - 3.2) reported “Always”. At 36 months (n=118), RB was reported “About half the time” among 20% (CI:13 - 29) of the patients, “Usually” for 3% (CI:1 -8) and 1% (CI:0.2- 5) reported “Always” (figure 1). History of hemorrhoids CTCAE grade I or II (HR:1.7, p=.024), current smoker (HR:0.41, p=.05) and 6 months of ADT compared to no ADT (HR:0.27, p≤.01) were statistically significant factors associated with RB in at least one time point during the follow-up period in both the univariate and the multivariate analysis. No other factors were statistically significant. At 24 months, 31% (CI: 15-51) of patients with hemorrhoids had RB at least half of the time compared to 13% (CI: 8-19) of those without hemorrhoids. Among patients with 6 months of ADT 2.5% (CI:0.1-13) reported RB compared to 14% (CI:4-32) of those with no ADT. Finally, 5% (CI:1-15) of patients who were current smokers reported RB compared to 18% (CI:11-28) of non-smokers.

Conclusion:

RB is an important adverse event following curative radiotherapy for PCa. As expected a history of hemorrhoids was associated with larger risk of RB during follow-up. This finding only illustrates the importance of excluding patients with other known causes of rectal bleeding from dose-effect analysis. Further, this analysis demonstrated that patients who received ADT for a maximum of 6 months or were current smokers had reduced risk for RB. The impact of smoking and the length of ADT treatment as well as other potential risk factors for RB need further investigation.

Keywords: rectal bleeding, radiotherapy, prostate cancer

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Maria Isabel Martínez 1 , Visus Ignacio 1 , Margarita Illas 2 , Uxue Zarandona 3 , Marta Barrado 1 , Sola Amaya 1 , Irene Martínez 1 , Flamarique Sonia 1 , Rico Mikel 1 , Lorenzana Patricia 1 , Paola Jablonska 1 , Burillo Erkuden 1 , Ruiz Ujue 1 , Libe Almondarain 1 , Darwin Pozo 1 , Naiara Fuentemilla 4 , Santiago Pellejero 4 , Raquel Villanueva 5 , Noelia García 5 , Enrique Martínez 1 , Elena Villafranca 1 1 Universitary Hospital of Navarre, Radiation Oncology, Pamplona, Spain. 2 Navarrabiomed Research Center, Radiation Oncology, Pamplona, Spain. 3 Universitary Hospital of Navarre, Psicooncology, Pamplona, Spain. 4 Universitary Hospital of Navarre, Medical Physics, Pamplona, Spain. 5 Universitary Hospital of Navarre, Oncology Nursing, Pamplona, Spain