Effects of sucralfate on acute and late bowel discomfort following radiotherapy of pelvic cancer.

Abstract

It is suggested that sucralfate can be of beneficial value in diminishing bowel discomfort during treatment and, most importantly, sucralfate also reduces the late bowel disturbances that follow radiotherapeutic treatment of pelvic malignancies. The earlier proposed mechanisms of action (eg, protection of denuded mucosa, cytoprotective properties, binding bile acids) seem adequate to explain the present effects of sucralfate.

Daily-Diary Evaluated Side-Effects of Conformal versus Conventional Prostatic Cancer Radiotherapy Technique

“…Sucralfate also reduces intestinal discomforts in patients treated with pelvic fields (20,21,25). Data are comparable since the only change in treatment technique was the conversion to conformal radiotherapy technique, including the prostate, with a 2-cm margin.…”

“…One group of patients was treated with conventional 4-field box technique including the pelvic region. Those patients were also included in a double-blind, prospective, randomized study comparing placebo and sucralfate during treatment (21). Seventy patients were included in that study.…”

“…This was also shown recently with a self-assessment questionnaire (19). In an attempt to decrease these problems Henriksson et al (20) in a prospective, controlled, randomized, doubleblind study showed that sucralfate decreased both acute and late intestinal toxicity, in patients treated with radiotherapy where the pelvic area was involved (20,21). Improved planning of external beam radiotherapy has now rapidly emerged by using a CT-based three-dimensional (3-D) planning and conformal beam radiotherapy (7,22).…”

“…All patients were given the same daily diary (21) and were instructed to report the daily intestinal function as listed in Table 1. To the 72 patients treated with conformal technique (except the 16 first patients) the daily diary also contained questions about urinary function ( Table 1).…”

Radiation-Induced Problems in Colorectal Surgery

“…Topical treatments such as antiinflammatory enemas and suppositories are usually considered first-line therapy, but studies evaluating their protective role have shown mixed results. Two double-blind, placebocontrolled trials have shown improved stool consistency and reduced frequency in patients using sucralfate enemas, 34,35 as well as a reduction in severity of rectal bleeding after 4 weeks of treatment. 36 Others have suggested that sucralfate enemas do not reduce the rate of rectal bleeding and may even be associated with worsened bowel function.…”