IMRT

Foecal incontinence • Prospective study (> 500 pts ), self reported questionnaires • Taking into account severity and duration of symptoms • V40>80% : predictor of Mean Incontinence Score together with previous bowel symptoms, antiypertensive, surgery • Two patterns for occurrence of foecal incontinence after RT : – 1: consequent to acute effects and mainly responsible for peak events (ca ½ pts recovering from symptoms) – 2: needs longitudinal analysis- it results form the irradiation of large fraction of the rectum at intermediate doses (V40), presence of pretreatment bowel symptoms, previous abdominal-pelvivc surgery for chronic incontinence • Vascular damage, more than damage to sacral nerve ( hypertensive drugs work) Fiorino et al , 2011