{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:00:18Z","timestamp":1755219618896,"version":"3.43.0"},"reference-count":18,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite advances in radiotherapy planning, some long\u2010term prostate cancer survivors experience persistent symptoms. Although overall quality of life appears comparable between patients treated with definitive and salvage radiotherapy and aligns with normative data, prostate\u2010specific deficits\u2014particularly bowel symptoms\u2014may persist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study assessed prostate\u2010specific quality of life using the EORTC QLQ\u2010PR25 questionnaire in 141 patients with localized or locally advanced prostate cancer (T1\u20134 N0 M0) treated with external radiotherapy between 2011 and 2021. After a median follow\u2010up of 63.6 months, bowel symptom scores and radiation doses to the anal canal and rectum were analyzed in 71 patients who received definitive radiotherapy (median dose: 78\u2009Gy) and 70 who received salvage radiotherapy (median dose: 70\u2009Gy). Bowel symptom scores were correlated with previously reported global health status scores (EORTC QLQ\u2010C30) from the same cohort and compared to those of a reference population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tumor stage distribution (localized vs. locally advanced) was similar between groups. Patients in the definitive group were older at the time of survey than those in the salvage group (79 years vs. 75 years; <jats:italic>p<\/jats:italic>\u2009=\u20090.009). Mean doses to the anal canal and rectum were comparable between groups, reflecting consistent application of dose constraints across treatment intents. EORTC QLQ\u2010PR25 scores, including bowel symptom scores, did not differ significantly between the groups. Patients reporting bowel symptoms (<jats:italic>n<\/jats:italic>\u2009=\u200992) received significantly higher mean doses to the anal canal (41.0\u2009Gy vs. 35.1\u2009Gy; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), whereas rectal doses were similar. Mean anal canal dose (<jats:italic>D<\/jats:italic>mean) correlated with bowel symptom scores (<jats:italic>r<\/jats:italic>\u2009=\u20090.307; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), whereas no correlation was observed for mean rectal doses. A <jats:italic>D<\/jats:italic>mean threshold of 32\u2009Gy to the anal canal differentiated patients with and without bowel symptoms. Higher bowel symptom scores were associated with lower global health status (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.469; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Compared to the reference population, patients showed significantly and clinically relevant higher bowel symptom scores, indicating a greater symptom burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bowel symptoms are a significant concern after radiotherapy for prostate cancer and are associated with reduced quality of life. Since higher anal canal doses correlate with increased symptom burden, greater efforts to spare this structure during treatment are warranted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>This study was retrospectively registered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.70004","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T01:11:12Z","timestamp":1750813872000},"page":"1181-1188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Late Bowel Symptoms in Long\u2010Term Survivors of Prostate Cancer Following Radiotherapy"],"prefix":"10.1002","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7435-9337","authenticated-orcid":false,"given":"Isabella","family":"Gruber","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University Hospital Regensburg Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Koelbl","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospital Regensburg Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria M.","family":"Meier","sequence":"additional","affiliation":[{"name":"University Regensburg Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214122"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.11.044"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2300018"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15133454"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-84257-8"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.01.014"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.02.006"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.07.030"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.5.365"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-022-02204-3"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.03.002"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.04.004"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.08.023"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.03.034"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.10.002"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2019.1635267"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2013.865077"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.9334"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T04:53:07Z","timestamp":1754542387000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,24]]},"references-count":18,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/pros.70004"],"URL":"https:\/\/doi.org\/10.1002\/pros.70004","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"type":"print","value":"0270-4137"},{"type":"electronic","value":"1097-0045"}],"subject":[],"published":{"date-parts":[[2025,6,24]]},"assertion":[{"value":"2025-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}