Diabetes and Performance Status Predict Severe, Persistent Radiation Proctitis: Long-Term Endoscopic Findings From STELLAR Trial.
Ningyu Wang, Tongzhen Xu, Haoyue Li et al.
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In 30 seconds
This randomized controlled trial analyzed long-term endoscopic findings in 74 patients with locally advanced rectal cancer from the STELLAR study. It identified diabetes mellitus and Eastern Cooperative Oncology Group performance status as independent predictors of severe and persistent chronic radiation proctitis (CRP). The incidence of severe CRP was 33.3% in the short-course radiation therapy group compared to 20.0% in the long-course chemoradiation therapy group.
Key findings
- Diabetes mellitus was a significant risk factor for severe CRP (HR, 5.46; P = .024).
- Performance status 1 predicted persistent severe CRP (HR, 8.81; P = .016).
- Endoscopic severity peaked at 2 years post-radiation, with a recovery trend in the TNT group.
Why it matters
Understanding the predictors of severe chronic radiation proctitis can help clinicians identify high-risk patients and tailor surveillance and management strategies, potentially improving patient outcomes after treatment for rectal cancer.