Gastrointestinal symptoms after pelvic radiotherapy: a new understanding to improve management of symptomatic patients

Andreyev, Jervoise

doi:10.1016/s1470-2045(07)70341-8

Cited by 298 publications

(244 citation statements)

References 71 publications

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“…This negative effect on quality of life is of a moderate to severe level in 20%-40% of patients, depending on the type of tumour (23,29). In the current study, the DSS was used to assess the severity of the damage created in the ileum and the colon.…”

Section: Discussionmentioning

confidence: 99%

Protective Effects of Quercetin on Intestinal Damage Caused by Ionizing Radiation

Pişkin¹,

Aydın²,

Baş³

et al. 2018

Haseki

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Radyasyona Bağlı İntestinal Hasarda Quercetin'in Koruyucu EtkisiAim: The aim of this study was to evaluate the protective use of quercetin in a rat model of radiation-induced enteritis and colitis.Methods: Twenty four adult rats were randomly divided into four groups. Group SHAM was given only physiological saline, group QUER was given quercetin 50 mg/kg for 15 days, group RAD was given only irradiation and group QUER+RAD was given quercetin 50 mg/kg, and then irradiated. Twenty four hours after the exposure to radiation, all rats were euthanized for the evaluation of the ileum and colon morphology and biochemical measurements. Results:Compared with the SHAM group, the serum malondialdehyde (MDA) level was significantly higher in group RAD (p=0.004) and was significantly decreased in group QUER+RAD (p=0.015). The MDA levels in the ileum and colon tissues were significantly higher in group RAD (p=0.004 and p=0.002, respectively), while treatment with quercetin significantly reduced lipid peroxidation in both tissues in group QUER+RAD (p=0.015 and p=0.009, respectively). Compared with the control group, the serum total antioxidant status (TAS) level was significantly lower in Group RAD (p=0.002) and was significantly increased in group QUER+RAD (p=0.009). TAS in the ileum and colon tissues were significantly lower in group RAD (p=0.002 and p=0.002) and were significantly higher in both tissues in group QUER+RAD (p=0.002 and p=0.002, respectively). Conclusion:This study confirmed that, in the model of radiationinduced ileitis and colitis in rats, quercetin effectively decreased oxidative stress and inflammatory damage to both ileum and colon tissues.Keywords: Quercetin, intestine damage, oxidative stress, radiation, rat Amaç: Bu çalışmanın amacı rat modelinde radyasyona bağlı oluşan enterit ve kolit tedavisinde quercetin'in koruyucu rolünü değerlendirmektir. Yöntemler:Yirmi dört yetişkin rat randomize olarak dört gruba ayrıldı. Group SHAM'a sadece salin, grup QUER'e 15 gün boyunca 50 mg/ kg quercetin, grup RAD'a sadece radyasyon ve grup QUER+RAD'a 15 gün boyunca 50 mg/kg quercetin ardından radyasyon uygulandı. Radyasyon maruziyetinden 24 saat sonra ileum ve kolon morfolojisi ve biyokimyasal parametrelerin değerlendirilmesi için ratlara ötenazi uygulandı. Bulgular: SHAM grubuyla karşılaştırıldığında, serum malondialdehit (MDA) seviyesi grup RAD'da istatistiksel olarak anlamlı derecede yüksek (p=0,004) ve grup QUER+RAD'da düşük bulundu (p=0,015). İleum ve kolon dokularındaki MDA seviyesi grup RAD'da anlamlı olarak daha yüksek (sırasıyla; p=0,004 ve p=0,002) idi. Grup QUER+RAD'da ise her iki dokuda azalmış olarak bulundu (sırasıyla; p=0,015 ve p=0,009). Kontrol grubuyla karşılaştırıldığı zaman, serum total antioksidan kapasite (TAK) seviyesi grup RAD'da istatistiksel olarak anlamlı derecede düşük (p=0,002) ve grup QUER+RAD'da ise yüksek bulundu (p=0,009). İleum ve kolon dokularındaki TAK seviyesi grup RAD'da istatistiksel olarak anlamlı derecede düşük iken (sırasıyla; p=0,002 ve p=0,002), grup QUER+RAD'da ise her iki ...

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Section: Discussionmentioning

confidence: 99%

Protective Effects of Quercetin on Intestinal Damage Caused by Ionizing Radiation

Pişkin¹,

Aydın²,

Baş³

et al. 2018

Haseki

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“…Additional contributing factors, such as bacterial overgrowth, bile acid malabsorption and lactose intolerance, have been described [22,23]. Research suggests that many patients have highly treatable bowel dysfunctions, if the cause of the dysfunction is correctly diagnosed [24].…”

Section: Discussionmentioning

confidence: 99%

A comprehensive longitudinal overview of health-related quality of life and symptoms after treatment for rectal cancer in the TME trial

et al. 2015

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Background: Total mesorectal excision (TME) combined with preoperative short-term radiotherapy (PRT) reduces local recurrence rates in rectal cancer treatment. However, treatment with radiotherapy increased morbidity and did not result in a longer survival. The aim of this analysis is to provide a comprehensive longitudinal overview of the health-related quality of life (HRQL) and symptoms experienced by rectal cancer patients in the Dutch randomized TME trial from baseline until 14 years after treatment. Methods: Rectal cancer patients (n ¼1530) were randomly allocated to PRT (5 Â 5 Gy) followed by TME or to TME alone. At baseline, 3, 6, 12, 18, and 24 months, 5 years and 14 years after treatment HRQL was evaluated in surviving patients (n ¼606, at 14 years after treatment). Results: None of the general symptoms differed significantly between PRT + TME and TME. However, in both treatment arms the general symptoms were increased at the diagnosis of rectal cancer, after surgery and by aging. With PRT + TME bowel symptoms were increased, specifically more fecal incontinence was reported at all time points, resulting in more use of pads for fecal incontinence (PRT + TME vs. TME at 5 years 51.5% vs. 30.5%, respectively, and at 14 years 56.4% vs. 37.1%, respectively).Conclusions: This longitudinal analysis shows that general symptoms in both groups are increased at the diagnosis of rectal cancer, after surgery and by aging, but not by RT. However, irradiated patients reported more bowel dysfunction at all time points.

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“…In addition, we have shown that ''typical'' symptoms widely thought to be representative of specific toxicity, such as radiation proctopathy, are surprisingly unreliable. For example, 1 in 3 new GI symptoms arising after pelvic tumor irradiation, which are not due to the radiotherapy at all (20,22,23). Indeed, it is not widely appreciated that in PRD, as in other GI diseases, pathological change in the GI tract correlates poorly with symptoms (24,27).…”

Section: Principle 2: Symptoms Do Not Reliably Predict Their Causementioning

confidence: 99%

GI Consequences of Cancer Treatment: A Clinical Perspective

Andreyev¹

2016

Radiation Research

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Gastrointestinal symptoms after pelvic radiotherapy: a new understanding to improve management of symptomatic patients

Cited by 298 publications

References 71 publications

Protective Effects of Quercetin on Intestinal Damage Caused by Ionizing Radiation

Protective Effects of Quercetin on Intestinal Damage Caused by Ionizing Radiation

A comprehensive longitudinal overview of health-related quality of life and symptoms after treatment for rectal cancer in the TME trial

GI Consequences of Cancer Treatment: A Clinical Perspective

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