Radiation proctitis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rekha, M.D., Mahshid Mir, M.D. [2]


Overview

The reported incidence of any transient acute radiation proctitis is thought to range from 50% to 100%. The incidence of chronic radiation proctitis is estimated at 2%–20%

Epidemiology and Demographics

Incidence and prevalance

  • The exact incidence of the radiation proctitis is not available and largely depends on number of factors such as:
    • The dose of radiation
    • Area of exposure
    • Method of delivery
    • The use of cytoprotective agents
    • Dose fraction regimens
    • The interval between sessions
  • The reported incidence of any transient acute radiation proctitis is thought to range from 50% to 100%.[1]
  • The incidence of chronic radiation proctitis is estimated to be 2000-20,000 in every 100,000 people.[2]
  • The incidence rate of radiation proctitis in patients treated with the external beam radiation therapy is estimated to range from 2000-39,000 in every 100,000 patients depending upon the severity and grade of proctitis.[3]
  • The incidence rate of radiation proctitis in patients treated with brachy-therapy is 8000-13,000 in every 100,000 patients when used alone and up to 21,000 in every 100,000 ptients in combination with other modalities.[4]
  • Smith et al. reported a 20,000 in every 100,000 patients incidence of RP with a radiation dose up to 7.500 Cgy and a 60,000 in every 100,000 patients incidence of RP with doses greater than 7.500 Cgy.[5]
  • Furthermore, it is unclear whether the incidence of radiation proctitis is increasing or decreasing. Although newer radiotherapy techniques may reduce the damage to surrounding tissues, potentially reducing the incidence of proctitis, it is possible that the higher doses used may have the opposite effect. Also, as the number of cancer patients receiving radiation to the pelvic area increases, the incidence of radiation proctitis may also increase.

Age

  • The prevalence of radiation proctitis is more among older age group (over 60 years) patients. This may be a reflection of the increase frequency of predisposing malignancy requiring radiotherapy in this age group.However, younger age group seems more susceptible to the risk of radiation injury.

Race

  • There is no racial predilection to radiation proctitis.

Gender

  • Radiation proctitis affects men and women equally.

References

  1. Weiner, Joseph Paul; Wong, Andrew Thomas; Schwartz, David; Martinez, Manuel; Aytaman, Ayse; Schreiber, David (2016). "Endoscopic and non-endoscopic approaches for the management of radiation-induced rectal bleeding". World Journal of Gastroenterology. 22 (31): 6972. doi:10.3748/wjg.v22.i31.6972. ISSN 1007-9327.
  2. Tagkalidis PP, Tjandra JJ (2001). "Chronic radiation proctitis". ANZ J Surg. 71 (4): 230–7. PMID 11355732.
  3. Beard CJ, Propert KJ, Rieker PP, Clark JA, Kaplan I, Kantoff PW; et al. (1997). "Complications after treatment with external-beam irradiation in early-stage prostate cancer patients: a prospective multiinstitutional outcomes study". J Clin Oncol. 15 (1): 223–9. doi:10.1200/JCO.1997.15.1.223. PMID 8996146.
  4. Zeitlin SI, Sherman J, Raboy A, Lederman G, Albert P (1998). "High dose combination radiotherapy for the treatment of localized prostate cancer". J Urol. 160 (1): 91–5, discussion 95-6. PMID 9628612.
  5. Smit, W.G.J.M.; Helle, P.A.; Van Putten, W.L.J.; Wijnmaalen, A.J.; Seldenrath, J.J.; Van Der Werf-Messing, B.H.P. (1990). "Late radiation damage in prostate cancer patients treated by high dose external radiotherapy in relation to rectal dose". International Journal of Radiation Oncology*Biology*Physics. 18 (1): 23–29. doi:10.1016/0360-3016(90)90262-I. ISSN 0360-3016.

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