Treatment of radiation-induced pelvic damage after radiation therapy for prostate cancer

Background. Radiation-induced damage to the pelvic organs (post-radiation proctitis, cystitis, urethritis) is a frequent complication after radiotherapy for prostate cancer. The reported frequency of late radiation damage to the pelvic organs is up to 30 %. Material and methods. The paper presents treatment outcomes of 149 with radiation-induced pelvic injuries caused by brachitherapy (15 patients) and combination treatment including brachitherapy and external beam radiation therapy (28 patients) for stage T1-3N0M0 prostate cancer. Radiation-induced rectitis (proctitis) was revealed in 149 patients and complications of the urinary tract after radiation treatment were noted in 107 (72 %) patients. Potency failure was observed in 98 % of cases. All patients received conservative treatment and 8 (5 %) of these patients underwent surgery after inefficient conservative treatment. Results. Favorable effect of conservative therapy of radiation-induced rectitis was obtained in 141 (95 %) patients. Eight (5 %) patients underwent colostomy due to the formation of vesicle-rectal fistula. Chemical cauterization of the mucosa of the bladder and rectum in patients with erosive hemorrhagic and hemorrhagic rectitis and cystitis was effective and safe. The frequency of post-radiation complications was found to be less after brachitherapy than after combination treatment using brachitherapy and external beam radiation.