Therapeutics in Radiation-induced Proctopathy: A Systematic Review (original) (raw)

Exploring the Management of Radiation Proctitis in Current Clinical Practice

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016

This literature review was performed by conducting a systematic search of PUBMED, MEDLINE, PMC, GOOGLE SEARCH including all articles up to February 2015. Keywords used for the search included 'radiation proctitis', 'radiation proctopathy', 'management of radiation proctitis', or 'radiotherapy complications of pelvic malignancies'. RESULTS Details are given in [Table/Fig-1].

Overview of Radiation Therapy for Treating Rectal Cancer

Annals of Coloproctology, 2014

A major outcome of importance for rectal cancer is local control. Parallel to improvements in surgical technique, adjuvant therapy regimens have been tested in clinical trials in an effort to reduce the local recurrence rate. Nowadays, the local recurrence rate has been reduced because of both good surgical techniques and the addition of radiotherapy. Based on recent reports in the literature, preoperative chemoradiotherapy is now considered the standard of care for patients with stages II and III rectal cancer. Also, short-course radiotherapy appears to pro vide effective local control and the same overall survival as more long-course chemoradiotherapy schedules and, therefore, may be an appropriate choice in some situations. Capecitabine is an acceptable alternative to infusion fluorouracil in those patients who are able to manage the responsibilities inherent in self-administered, oral chemotherapy. However, concurrent administration of oxaliplatin and radiotherapy is not recommended at this time. Radiation therapy has long been considered an important adjunct in the treatment of rectal cancer. Although no prospective data exist for several issues, we hope that in the near future, patients with rectal cancer can be treated by using the best combination of surgery, radiation therapy, and chemotherapy in near future.

Radiation induced toxicity in rectal cancer patients

Acta chirurgica Iugoslavica, 2016

Preoperative radiotherapy ? chemotherapy became the standard treatment for locally advanced rectal cancer. Despite better local control with this approach, there was not seen a significant improvement in overall survival and disease free survival, yet. The main disadvantage is toxicity that can be developed, especially concomitantly with chemotherapy. Toxicity can be acute and late. Acute complications are transitory, but late might lead to permanent damage and consequently are more significant for patients. Today, there are technical opportunities in reduction of acute and late radiation toxicity in the treatment of rectal cancer. With the implementation of 3D conformal radiotherapy (3D CRT) and intensity modulated radiation therapy (IMRT) techniques in clinical practice significant accuracy, better dose distribution and safety in the treatment of rectal cancer patients is achieved, with maximal sparing of surrounding normal tissue. Utilization of advanced techniques and new softwa...

Conservative Therapies for Hemorrhagic Radiation Proctitis: a Review

Revista do Hospital …, 2003

Chronic radiation proctitis represents a challenging condition seen with increased frequency due to the common use of radiation for treatment of pelvic cancer. Hemorrhagic radiation proctitis represents the most feared complication of chronic radiation proctitis. There is no ...

Chronic radiation proctitis: tricks to prevent and treat

International journal of colorectal disease, 2015

The purpose of this study was to give an overview of the measures used to prevent chronic radiation proctitis (CRP) and to provide an algorithm for the treatment of CRP. Medical literature databases including PubMed and Medline were screened and critically analyzed for relevance in the scope of our purpose. CRP is a relatively frequent late side effect (5-20%) and mainly dependent on the dose and volume of irradiated rectum. Radiation treatment (RT) techniques to prevent CRP are constantly improving thanks to image-guided RT and intensity-modulated RT. Also, newer techniques like protons and new devices such as rectum spacers and balloons have been developed to spare rectal structures. Biopsies do not contribute to diagnosing CRP and should be avoided because of the risk of severe rectal wall damage, such as necrosis and fistulas. There is no consensus on the optimal treatment of CRP. A variety of possibilities is available and includes topical and oral agents, hyperbaric oxygen the...

Assessment of small intestinal damage in patients treated with pelvic radiotherapy

Oncology Reports, 1998

Pelvic radiotherapy almost always induces intestinal symptoms. We investigated the radiation-induced damage to the small intestinal mucosa and evaluated its relationship with symptoms, using cellobiose/mannitol permeability test (CE/MA) and plasma postheparin diamine oxidase test (PHD) in 20 patients treated with pelvic radiotherapy. The symptoms developed during radiotherapy were noted. Intestinal permeability significantly (p=0.013) increased from 0.021±0.026 to 0.047+0.055 (mean ± SD) after 15 days of radiotherapy, while it returned to normal values (0.010+0.015) at the end of radiotherapy. PHD values did not change. All patients developed intestinal symptoms. These findings indicate that pelvic radiotherapy induces an early small bowel mucosa damage followed by mucosal adaptation. Acute intestinal symptoms during pelvic radiotherapy may not depend only on small intestinal mucosal damage.