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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Radiation proctitis primary prevention

Introduction

Overview

Overview

Primary prevention of radiation proctitis can be done by the modifications of radiation techniques and doses or by use of prophylactic adjunct medical and surgical therapies.

Primary Prevention

Primary Prevention

Primary prevention strategies include: [1][2]

  • modifications of radiation techniques and doses (Ex: intensity-modulated radiation therapy, image-guided radiation therapy decreases the rectal toxicity while maximizing the dose to the tumor.)[3]
  • Identifying high risk patients, based on genomic study helps taking extra precautions in those patients.[4][5]
  • Use of adjuvant medical treatment (Ex: amifostine, sucralfate, 5-aminosalicylic acid, or sulphasalazine) have been associated with the minimal effect and are rarely used.[6][7][8]
  • Synbiotics and microbiotics can be used to prevent radiation proctitis by altering the intestinal flora.[9][10]
  • Implantation of of endorectal balloons and novel rectum spacers lead to reduction in the maximum dose to the rectum and the total volume of irradiated rectum[11]
  • Prophylactic surgical therapies in the form of insertion of biodegradable mesh slings, intra-pelvic breast prostheses or omentoplasty can be done during operative resection, whenever postoperative radiotherapy may be indicated.[12]
References

References

  1. ↑ Hille A, Christiansen H, Pradier O, Hermann RM, Siekmeyer B, Weiss E; et al. (2005). “Effect of pentoxifylline and tocopherol on radiation proctitis/enteritis”. Strahlenther Onkol. 181 (9): 606–14. doi:10.1007/s00066-005-1390-y. PMID 16170489.
  2. ↑ Babb RR (1996). “Radiation proctitis: a review”. Am J Gastroenterol. 91 (7): 1309–11. PMID 8677984.
  3. ↑ Fonteyne V, De Neve W, Villeirs G, De Wagter C, De Meerleer G (2007). “Late radiotherapy-induced lower intestinal toxicity (RILIT) of intensity-modulated radiotherapy for prostate cancer: the need for adapting toxicity scales and the appearance of the sigmoid colon as co-responsible organ for lower intestinal toxicity”. Radiother Oncol. 84 (2): 156–63. doi:10.1016/j.radonc.2007.06.013. PMID 17692976.
  4. ↑ Fachal L, Gómez-Caamaño A, Barnett GC, Peleteiro P, Carballo AM, Calvo-Crespo P; et al. (2014). “A three-stage genome-wide association study identifies a susceptibility locus for late radiotherapy toxicity at 2q24.1”. Nat Genet. 46 (8): 891–4. doi:10.1038/ng.3020. PMID 24974847.
  5. ↑ West CM, Barnett GC (2011). “Genetics and genomics of radiotherapy toxicity: towards prediction”. Genome Med. 3 (8): 52. doi:10.1186/gm268. PMC 3238178. PMID 21861849.
  6. ↑ Stellamans K, Lievens Y, Lambin P, Van den Weyngaert D, Van den Bogaert W, Scalliet P; et al. (2002). “Does sucralfate reduce early side effects of pelvic radiation? A double-blind randomized trial”. Radiother Oncol. 65 (2): 105–8. PMID 12443806.
  7. ↑ Simone NL, Ménard C, Soule BP, Albert PS, Guion P, Smith S; et al. (2008). “Intrarectal amifostine during external beam radiation therapy for prostate cancer produces significant improvements in Quality of Life measured by EPIC score”. Int J Radiat Oncol Biol Phys. 70 (1): 90–5. doi:10.1016/j.ijrobp.2007.05.057. PMC 2267374. PMID 17855015.
  8. ↑ Koukourakis MI, Kyrgias G, Panteliadou M, Papadopoulou A, Tsiarkatsi M, Papachristou E; et al. (2013). “Dose escalation of amifostine for radioprotection during pelvic accelerated radiotherapy”. Am J Clin Oncol. 36 (4): 338–43. doi:10.1097/COC.0b013e318248d882. PMID 22643562.
  9. ↑ Ferreira MR, Muls A, Dearnaley DP, Andreyev HJ (2014). “Microbiota and radiation-induced bowel toxicity: lessons from inflammatory bowel disease for the radiation oncologist”. Lancet Oncol. 15 (3): e139–47. doi:10.1016/S1470-2045(13)70504-7. PMID 24599929.
  10. ↑ Nascimento M, Aguilar-Nascimento JE, Caporossi C, Castro-Barcellos HM, Motta RT (2014). “Efficacy of synbiotics to reduce acute radiation proctitis symptoms and improve quality of life: a randomized, double-blind, placebo-controlled pilot trial”. Int J Radiat Oncol Biol Phys. 90 (2): 289–95. doi:10.1016/j.ijrobp.2014.05.049. PMID 25304789.
  11. ↑ Smeenk RJ, van Lin EN (2013). “Application of anorectal sparing devices in prostate radiotherapy”. Radiother Oncol. 106 (2): 155–6. doi:10.1016/j.radonc.2013.02.004. PMID 23474285.
  12. ↑ Meric F, Hirschl RB, Mahboubi S, Womer RB, Goldwein J, Ross AJ; et al. (1994). “Prevention of radiation enteritis in children, using a pelvic mesh sling”. J Pediatr Surg. 29 (7): 917–21. PMID 7931970.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: