@entity4272 following stereotactic body radiation therapy for XXXX .

@entity1 @entity137 @entity263 @entity8721 @entity548 @entity4272
UNASSIGNED: BackgroundProctitis after radiation therapy for @entity263 remains an ongoing clinical challenge and critical quality of life issue. SBRT could minimize @entity137 by reducing the volume of rectum receiving high radiation doses and offers the potential radiobiologic benefits of hypofractionation. This study sought to evaluate the incidence and severity of @entity4272 following SBRT for @entity263 .MethodsBetween February 2008 and July 2011, 269 @entity1 with clinically localized @entity263 were treated definitively with SBRT monotherapy at Georgetown University Hospital. All @entity1 were treated to 35-36.25Gy in 5 fractions delivered with the CyberKnife Radiosurgical System (Accuray). @entity548 was recorded and scored using the CTCAE v.4. @entity8721 were graded using the Vienna Rectoscopy Score (VRS). @entity4272 was assessed via the Bowel domain of the Expanded Prostate Index Composite (EPIC)-26 at baseline and at 1, 3, 6, 9, 12, 18 and 24  months post-SBRT.ResultsThe median age was 69 years with a median prostate volume of 39 cc. The median follow-up was 3.9 years with a minimum follow-up of two years. The 2-year actuarial incidence of late rectal bleeding    grade 2 was 1.5%. Endoscopy revealed VRS Grade 2 @entity8721 in 11% of @entity1 . All @entity4272 symptoms increased at one month post-SBRT but returned to near-baseline with longer follow-up. The most bothersome symptoms were bowel urgency and frequency. At one month post-SBRT, 11.2% and 8.5% of @entity1 reported a moderate to big problem with bowel urgency and frequency, respectively. The EPIC bowel summary scores declined transiently at 1 month and experienced a second, more protracted decline between 6 months and 18 months before returning to near-baseline at two years post-SBRT. Prior to treatment, 4.1% of @entity1 felt their bowel function was a moderate to big problem which increased to 11.5% one month post-SBRT but returned to near-baseline at two years post-SBRT.ConclusionsIn this single institution cohort, the rate and severity of @entity4272 observed following SBRT is low. QOL decreased on follow-up; however, our results compare favorably to those reported for @entity1 treated with alternative radiation modalities. Future prospective randomized studies are needed to confirm these observations.
