A genetically determined dose-volume histogram predicts for rectal bleeding among patients treated with prostate brachytherapy.
PURPOSE: To examine whether possession of genetic alterations in the ATM (ataxia telangiectasia) gene is associated with rectal bleeding in a dose-dependent and volume-dependent manner.
METHODS AND MATERIALS: One hundred eight prostate cancer patients who underwent brachytherapy using either an (125)I implant, a (103)Pd implant, or the combination of external beam radiotherapy with a (103)Pd implant and had a minimum of 1 year follow-up were screened for DNA sequence variations in the 62 coding exons of the ATM gene using denaturing high-performance liquid chromatography. Rectal dose was reported as the volume (in cubic centimeters) of rectum receiving the brachytherapy prescription dose. The two-sided Fisher exact test was used to compare differences in proportions.
RESULTS: A significant correlation between the presence of any ATM sequence alteration and Grade 1 to 2 proctitis was obtained when the radiation dose to rectal tissue was quantified. Rectal bleeding occurred in 4 of 13 patients (31%) with a variant versus 1 of 23 (4%) without a genetic alteration for patients who had
CONCLUSIONS: The possession of genetic variants in the ATM gene is associated with the development of radiation-induced proctitis after prostate cancer radiotherapy for patients who receive the full prescription dose to either a low or a moderate volume of rectal tissue.
Published In/Presented At
Cesaretti, J. A., Stock, R. G., Atencio, D. P., Peters, S. A., Peters, C. A., Burri, R. J., Stone, N. N., & Rosenstein, B. S. (2007). A genetically determined dose-volume histogram predicts for rectal bleeding among patients treated with prostate brachytherapy. International journal of radiation oncology, biology, physics, 68(5), 1410–1416. https://doi.org/10.1016/j.ijrobp.2007.02.052
Medicine and Health Sciences | Oncology
Department of Radiation Oncology