Factores predictivos de Sangrado Rectal Crónico en pacientes tratados con radioterapia radical en cáncer de próstata
DOI:
https://doi.org/10.35954/SM2017.36.1.3Palabras clave:
Neoplasias de la Próstata; Radioterapia; Radiación Ionizante.Resumen
Objetivo: determinar los factores clínicos y dosimétricos que permitan predecir la aparición de sangrado rectal, luego de la radioterapia externa como tratamiento radical del cáncer de próstata, en pacientes tratados en el Instituto Nacional de Cáncer de Montevideo, Uruguay.
Materiales y Métodos: desde julio de 2008 a julio de 2011 fueron reclutados 132 pacientes. Se registró el
sangrado rectal a un mes, tres, seis, doce y dieciocho meses de seguimiento del paciente con las clasificaciones Radiation Therapy Oncology Group / European Organization for Research and Treatment of Cancer y Subjetive, Objetive, Management and Analytic/ The Late Effects on Normal Tisues, se utilizó un cuestionario construido y validado por el grupo cooperativo italiano: Programa de Investigaciones Aerotransportadas y Sensores Remotos. Los resultados fueron correlacionados con parámetros clínicos (antígeno prostático específico, Score de Gleason, T clínico, clase de riesgo, hipertensión y diabetes) y dosimétricos (Volumen de tratamiento, Volumen de recto, Dosis Total, Dosis Máxima al recto, Dosis media al recto) para valorar su influencia en la aparición de sangrado rectal.
Resultados: La incidencia de sangrado rectal a 18 meses es del 17,1%. El modelo de x2 mostró correlación entre el antígeno prostático específico al diagnóstico y el score de Radiation Therapy Oncology Group a 3 meses de seguimiento, con un poder de discriminación de un 72% según el modelo de regresión logística.
Conclusiones: Identificar los factores predictivos determinantes implica una mejora en la calidad de vida
de estos pacientes, los cuales suelen tener largas sobrevidas. El sangrado rectal es un efecto crónico que
puede traducir un daño radiobiológico en el tejido rectal, por un defecto en la reparación del daño de doble cadena del ácido desoxirribonucleico.
Recibido: Noviembre 2016 Aceptado: Marzo 2017 Correspondencia: José Castro 4403 Montevideo E-mail: lverarighi@gmail.com
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