Radiation Proctitis: Current Strategies in Management

Nhue, L.; Nagle, Deborah; Poylin, Vitaliy

doi:10.1155/2011/917941

Cited by 114 publications

(122 citation statements)

References 69 publications

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“…Decreasing the radiation dose or excluding the rectum from radiation area are judicious and alleviating procedures which are advised in radiation therapy, but these are not enough to ameliorate manifestations of the patients totally. Some agents such as rectal or oral misoprostol, rectal sucralfate and intravenous amifostine can be used 19 . However, there has not been any proven method in the literature yet, showing protective or preventive effects in ARP.…”

Section: ■ Discussionmentioning

confidence: 99%

“…A part of the ARP can be ameliorated by supportive anti-inflammatory therapies 19 . Using sildenafil would be an effective approach to prevent this pathological situation whose treatment has such drawbacks [19][20][21][22][23] .…”

Section: ■ Discussionmentioning

confidence: 99%

“…Using sildenafil would be an effective approach to prevent this pathological situation whose treatment has such drawbacks [19][20][21][22][23] . Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase (PDE)-5, which catalyzes the hydrolysis of cGMP and has a relaxant effect on the smooth muscle cells of the arterioles supplying the human corpus cavernosum 24 .…”

Section: ■ Discussionmentioning

confidence: 99%

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Evaluation of prophylactic and therapeutic effects of sildenafil on acute radiation proctitis in rats

Yavuz¹,

Ercan²,

Karagülle³

et al. 2018

Acta Cir. Bras.

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Purpose: To investigate the prophylactic and therapeutical effects of sildenafil in a model of acute radiation proctitis (ARP). Methods: All experimental procedures of this study was examined by histopathological, immunohistochemical and transmission electron microscopic analysis. Results: Our histopathological evaluations indicated significant increases in lesion severity, cryptic apsis, cryptitis, cryptic distortion, reactive atypia and infiltration depth of the control (proctitis) group. While the prophylaxis group and the treatment group had significantly lower scores. High-dose group showed similar results as prophylaxis group. Histopathological findings of the prophylaxis group was more significant than the treatment group. Immunoreactivities of IL-1β, FGF-2, TNF-α and HIF-1α increased in the control group especially in the epithelial and cryptic regions. On the contrary, sildenafil application caused significant decreases of inflammatory markers in all treatment groups, specifically better results in the prophylaxis group. Conclusion: The sildenafil has anti-inflammatory effects on ARP, as well as protective effects against ARP and the protective effect of sildenafil surpasses its therapeutic effect histopathologically.

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Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of prophylactic and therapeutic effects of sildenafil on acute radiation proctitis in rats

Yavuz¹,

Ercan²,

Karagülle³

et al. 2018

Acta Cir. Bras.

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“…Acute proctitis including symptoms of diarrhea, nausea, cramps, tenesmus, urgency, mucus discharge and minor bleeding occurs within 6 wk after the start of RT[11]. Severe bleeding, strictures, perforation, fistula and bowel obstruction occur in the chronic phase, which may not become apparent for months to years[12]. Concerning pelvic RT with concurrent 5-FU-based chemotherapy, severe acute small-bowel toxicity was found to be associated with radiation in a dose-dependent manner[13,14].…”

Section: Discussionmentioning

confidence: 99%

Local advanced rectal cancer perforation in the midst of preoperative chemoradiotherapy: A case report and literature review

Takase¹,

Yamashita²,

Sumi³

et al. 2017

WJCC

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Standard chemoradiotherapy (CRT) for local advanced rectal cancer (LARC) rarely induce rectal perforation. Here we report a rare case of rectal perforation in a patient with LARC in the midst of preoperative CRT. A 56-year-old male was conveyed to our hospital exhibiting general malaise. Colonoscopy and imaging tests resulted in a clinical diagnosis of LARC with direct invasion to adjacent organs and regional lymphadenopathy. Preoperative 5-fluorouracil-based CRT was started. At 25 d after the start of CRT, the patient developed a typical fever. Computed tomography revealed rectal perforation, and he underwent emergency sigmoid colostomy. At 12 d after the surgery, the remaining CRT was completed according to the original plan. The histopathological findings after radical operation revealed a wide field of tumor necrosis and fibrosis without lymph node metastasis. We share this case as important evidence for the treatment of LARC perforation in the midst of preoperative CRT.

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“…It occurs soon after the delivery of therapy and is dose dependent [9]. The degree of symptom severity varies, with approximately 15-20% of patients requiring an altered therapeutic course [11], but is usually self-limiting and often only supportive measures are required.…”

Section: Introductionmentioning

confidence: 99%

Nonendoscopic therapies for the management of radiation-induced rectal bleeding

Stacey

Green²

2013

Current Opinion in Supportive &Amp; Palliative Care

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There is no consensus on the optimal management of radiation-induced rectal bleeding. Therapies with evidence of benefit from randomized trials (of variable quality) are sucralfate enemas, antibiotics, vitamin A and HBO therapy. Other nonendoscopic therapies exist; however, there is a paucity of evidence to recommend these at present. Well constructed, randomized controlled trials are required to compare and evaluate therapeutic options.

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Radiation Proctitis: Current Strategies in Management

Cited by 114 publications

References 69 publications

Evaluation of prophylactic and therapeutic effects of sildenafil on acute radiation proctitis in rats

Evaluation of prophylactic and therapeutic effects of sildenafil on acute radiation proctitis in rats

Local advanced rectal cancer perforation in the midst of preoperative chemoradiotherapy: A case report and literature review

Nonendoscopic therapies for the management of radiation-induced rectal bleeding

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