A analysis of a tumor registry in Texas challenges the
notion that men suffering from inflammatory bowel disease ought not have
radiation therapy for prostate cancer.
Gestault and Swanson presented their findings at the recent ASCO
Genitourinary Conference (Abstract 15). They
searched a tumor registry and found 18 patients who suffered from inflammatory
bowel disease (either Crohn’s disease or ulcerative colitis) and were treated
with radiation between 2000 and 2010.
- · 12 were treated with EBRT – either IMRT or 3D-CRT
- · 6 were treated with low dose rate brachytherapy
- · 22% were in remission before treatment
- · 56% were taking a 5-ASA medication
- · 17% were taking prednisone
- · 6% were taking Remicade
- · 6 patients (40%) had grade 1 diarrhea at baseline
- · 2 had had an ostomy
After a median follow-up of 9.5 years:
- · 4 patients (22%) had grade 1 diarrhea, none of higher grade
- · 3 patients (17%) had grade 2 proctitis, none of higher grade
o All
of those had 3D-CRT, rather than IMRT
The authors conclude:
“Our findings suggest that IBD patients
experience minimal toxicity with IMRT-based radiation therapy.”
While a study of 18 patients is far too small to draw any
projectable conclusions, it does raise the interesting hypothesis that patients
with IBD should not automatically be ruled out for primary radiation treatment.
It might be prudent, however, to use a rectal spacer with such patients.
