A prospective randomized placebo-controlled double-blinded pilot study of misoprostol rectal suppositories in the prevention of acute and chronic radiation proctitis symptoms in prostate cancer patients

Abstract

Misoprostol rectal suppositories significantly reduce acute and chronic radiation proctitis symptoms in patients receiving radiation therapy for prostate cancer.

Recent advances in the management of radiation colitis

“…PGE2 and the PG analogs enprostil and misoprostol (Cytotec®) display radiation protection in animal studies [119][120][121][122] . Misoprostol suppositories also reduced symptoms of acute radiation colitis in patients undergoing radiation therapy for prostate cancer [123] . With respect to the mechanism of action, PGE2 has pro-proliferative and anti-apoptotic effects on epithelial cells in gastrointestinal injury.…”

Time patterns of changes in biomarkers, symptoms and histopathology during pelvic radiotherapy

“…By supplementing the diet with n(/3 PUFAs one might induce conversion to eicosanoids with less proinflammatory functions compared to the products of n(/6 PUFAs [5]. A pilot study with 16 prostate cancer patients receiving either external RT or external RT plus implants of brachytherapy showed that rectal suppositories with misoprostol, a PGE1-analogue, reduced proctitis symptoms 4 weeks after external RT [29]. However, no significant differences in histopathological or endoscopic scores could be found between six treated and five untreated patients.…”

Long-term prognosis in patients with severe late radiation enteropathy: A prospective cohort study

“…Clinical studies show increased risk of delayed radiation enteropathy in patients who experience severe acute GI symptoms during RT [6,9,[11][12][13][14][15] . Preventing acute symptoms could be a strategy to help reduce the risk of delayed radiation effects, as, for example, attempted by use of prostaglandin analogues or probiotics [16,17] . Radiation enteropathy can be eradicated by surgery in some cases, but palliative surgical or medical interventions are the option of choice for the majority of patients.…”