Radiation proctitis primary prevention: Difference between revisions
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* modifications of radiation techniques and doses (Ex: intensity-modulated radiation therapy, image-guided radiation therapy decreases the rectal toxicity while maximizing the dose to the tumor.)<ref name="pmid17692976">{{cite journal| author=Fonteyne V, De Neve W, Villeirs G, De Wagter C, De Meerleer G| title=Late radiotherapy-induced lower intestinal toxicity (RILIT) of intensity-modulated radiotherapy for prostate cancer: the need for adapting toxicity scales and the appearance of the sigmoid colon as co-responsible organ for lower intestinal toxicity. | journal=Radiother Oncol | year= 2007 | volume= 84 | issue= 2 | pages= 156-63 | pmid=17692976 | doi=10.1016/j.radonc.2007.06.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17692976 }}</ref> | * modifications of radiation techniques and doses (Ex: intensity-modulated radiation therapy, image-guided radiation therapy decreases the rectal toxicity while maximizing the dose to the tumor.)<ref name="pmid17692976">{{cite journal| author=Fonteyne V, De Neve W, Villeirs G, De Wagter C, De Meerleer G| title=Late radiotherapy-induced lower intestinal toxicity (RILIT) of intensity-modulated radiotherapy for prostate cancer: the need for adapting toxicity scales and the appearance of the sigmoid colon as co-responsible organ for lower intestinal toxicity. | journal=Radiother Oncol | year= 2007 | volume= 84 | issue= 2 | pages= 156-63 | pmid=17692976 | doi=10.1016/j.radonc.2007.06.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17692976 }}</ref> | ||
* Identifying high risk patients, based on genomic study helps taking extra precautions in those patients<ref name="pmid24974847">{{cite journal| author=Fachal L, Gómez-Caamaño A, Barnett GC, Peleteiro P, Carballo AM, Calvo-Crespo P et al.| title=A three-stage genome-wide association study identifies a susceptibility locus for late radiotherapy toxicity at 2q24.1. | journal=Nat Genet | year= 2014 | volume= 46 | issue= 8 | pages= 891-4 | pmid=24974847 | doi=10.1038/ng.3020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24974847 }}</ref><ref name="pmid21861849">{{cite journal| author=West CM, Barnett GC| title=Genetics and genomics of radiotherapy toxicity: towards prediction. | journal=Genome Med | year= 2011 | volume= 3 | issue= 8 | pages= 52 | pmid=21861849 | doi=10.1186/gm268 | pmc=3238178 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21861849 }}</ref> | * Identifying high risk patients, based on genomic study helps taking extra precautions in those patients<ref name="pmid24974847">{{cite journal| author=Fachal L, Gómez-Caamaño A, Barnett GC, Peleteiro P, Carballo AM, Calvo-Crespo P et al.| title=A three-stage genome-wide association study identifies a susceptibility locus for late radiotherapy toxicity at 2q24.1. | journal=Nat Genet | year= 2014 | volume= 46 | issue= 8 | pages= 891-4 | pmid=24974847 | doi=10.1038/ng.3020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24974847 }}</ref><ref name="pmid21861849">{{cite journal| author=West CM, Barnett GC| title=Genetics and genomics of radiotherapy toxicity: towards prediction. | journal=Genome Med | year= 2011 | volume= 3 | issue= 8 | pages= 52 | pmid=21861849 | doi=10.1186/gm268 | pmc=3238178 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21861849 }}</ref> | ||
* Use of adjuvant medical treatment (Ex: amifostine, sucralfate, 5-aminosalicylic acid, or sulphasalazine) have been associated with the minimal effect and are rarely used.<ref name="pmid12443806">{{cite journal| author=Stellamans K, Lievens Y, Lambin P, Van den Weyngaert D, Van den Bogaert W, Scalliet P et al.| title=Does sucralfate reduce early side effects of pelvic radiation? A double-blind randomized trial. | journal=Radiother Oncol | year= 2002 | volume= 65 | issue= 2 | pages= 105-8 | pmid=12443806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12443806 }}</ref><ref name="pmid17855015">{{cite journal| author=Simone NL, Ménard C, Soule BP, Albert PS, Guion P, Smith S et al.| title=Intrarectal amifostine during external beam radiation therapy for prostate cancer produces significant improvements in Quality of Life measured by EPIC score. | journal=Int J Radiat Oncol Biol Phys | year= 2008 | volume= 70 | issue= 1 | pages= 90-5 | pmid=17855015 | doi=10.1016/j.ijrobp.2007.05.057 | pmc=2267374 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17855015 }}</ref><ref name="pmid22643562">{{cite journal| author=Koukourakis MI, Kyrgias G, Panteliadou M, Papadopoulou A, Tsiarkatsi M, Papachristou E et al.| title=Dose escalation of amifostine for radioprotection during pelvic accelerated radiotherapy. | journal=Am J Clin Oncol | year= 2013 | volume= 36 | issue= 4 | pages= 338-43 | pmid=22643562 | doi=10.1097/COC.0b013e318248d882 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22643562 }}</ref> | * Use of adjuvant medical treatment (Ex: [[amifostine]], [[sucralfate]], 5-aminosalicylic acid, or sulphasalazine) have been associated with the minimal effect and are rarely used.<ref name="pmid12443806">{{cite journal| author=Stellamans K, Lievens Y, Lambin P, Van den Weyngaert D, Van den Bogaert W, Scalliet P et al.| title=Does sucralfate reduce early side effects of pelvic radiation? A double-blind randomized trial. | journal=Radiother Oncol | year= 2002 | volume= 65 | issue= 2 | pages= 105-8 | pmid=12443806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12443806 }}</ref><ref name="pmid17855015">{{cite journal| author=Simone NL, Ménard C, Soule BP, Albert PS, Guion P, Smith S et al.| title=Intrarectal amifostine during external beam radiation therapy for prostate cancer produces significant improvements in Quality of Life measured by EPIC score. | journal=Int J Radiat Oncol Biol Phys | year= 2008 | volume= 70 | issue= 1 | pages= 90-5 | pmid=17855015 | doi=10.1016/j.ijrobp.2007.05.057 | pmc=2267374 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17855015 }}</ref><ref name="pmid22643562">{{cite journal| author=Koukourakis MI, Kyrgias G, Panteliadou M, Papadopoulou A, Tsiarkatsi M, Papachristou E et al.| title=Dose escalation of amifostine for radioprotection during pelvic accelerated radiotherapy. | journal=Am J Clin Oncol | year= 2013 | volume= 36 | issue= 4 | pages= 338-43 | pmid=22643562 | doi=10.1097/COC.0b013e318248d882 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22643562 }}</ref> | ||
* Synbiotics and microbiotics can be used to prevent radiation proctitis by altering the intestinal flora.<ref name="pmid24599929">{{cite journal| author=Ferreira MR, Muls A, Dearnaley DP, Andreyev HJ| title=Microbiota and radiation-induced bowel toxicity: lessons from inflammatory bowel disease for the radiation oncologist. | journal=Lancet Oncol | year= 2014 | volume= 15 | issue= 3 | pages= e139-47 | pmid=24599929 | doi=10.1016/S1470-2045(13)70504-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24599929 }}</ref><ref name="pmid25304789">{{cite journal| author=Nascimento M, Aguilar-Nascimento JE, Caporossi C, Castro-Barcellos HM, Motta RT| title=Efficacy of synbiotics to reduce acute radiation proctitis symptoms and improve quality of life: a randomized, double-blind, placebo-controlled pilot trial. | journal=Int J Radiat Oncol Biol Phys | year= 2014 | volume= 90 | issue= 2 | pages= 289-95 | pmid=25304789 | doi=10.1016/j.ijrobp.2014.05.049 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25304789 }}</ref> | * [[Synbiotics]] and microbiotics can be used to prevent radiation proctitis by altering the intestinal flora.<ref name="pmid24599929">{{cite journal| author=Ferreira MR, Muls A, Dearnaley DP, Andreyev HJ| title=Microbiota and radiation-induced bowel toxicity: lessons from inflammatory bowel disease for the radiation oncologist. | journal=Lancet Oncol | year= 2014 | volume= 15 | issue= 3 | pages= e139-47 | pmid=24599929 | doi=10.1016/S1470-2045(13)70504-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24599929 }}</ref><ref name="pmid25304789">{{cite journal| author=Nascimento M, Aguilar-Nascimento JE, Caporossi C, Castro-Barcellos HM, Motta RT| title=Efficacy of synbiotics to reduce acute radiation proctitis symptoms and improve quality of life: a randomized, double-blind, placebo-controlled pilot trial. | journal=Int J Radiat Oncol Biol Phys | year= 2014 | volume= 90 | issue= 2 | pages= 289-95 | pmid=25304789 | doi=10.1016/j.ijrobp.2014.05.049 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25304789 }}</ref> | ||
* Implantation of of endorectal balloons and novel rectum spacers lead to reduction in the maximum dose to the rectum and the total volume of irradiated rectum<ref name="pmid23474285">{{cite journal| author=Smeenk RJ, van Lin EN| title=Application of anorectal sparing devices in prostate radiotherapy. | journal=Radiother Oncol | year= 2013 | volume= 106 | issue= 2 | pages= 155-6 | pmid=23474285 | doi=10.1016/j.radonc.2013.02.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23474285 }}</ref> | * Implantation of of endorectal balloons and novel rectum spacers lead to reduction in the maximum dose to the rectum and the total volume of irradiated rectum<ref name="pmid23474285">{{cite journal| author=Smeenk RJ, van Lin EN| title=Application of anorectal sparing devices in prostate radiotherapy. | journal=Radiother Oncol | year= 2013 | volume= 106 | issue= 2 | pages= 155-6 | pmid=23474285 | doi=10.1016/j.radonc.2013.02.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23474285 }}</ref> | ||
* Prophylactic surgical therapies in the form of insertion of biodegradable mesh slings, intra-pelvic breast prostheses or omentoplasty can be done during operative resection,whenever postoperative radiotherapy may be indicated.<ref name="pmid7931970">{{cite journal| author=Meric F, Hirschl RB, Mahboubi S, Womer RB, Goldwein J, Ross AJ et al.| title=Prevention of radiation enteritis in children, using a pelvic mesh sling. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 7 | pages= 917-21 | pmid=7931970 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7931970 }}</ref> | * Prophylactic surgical therapies in the form of insertion of biodegradable mesh slings, intra-pelvic breast prostheses or omentoplasty can be done during operative resection,whenever postoperative radiotherapy may be indicated.<ref name="pmid7931970">{{cite journal| author=Meric F, Hirschl RB, Mahboubi S, Womer RB, Goldwein J, Ross AJ et al.| title=Prevention of radiation enteritis in children, using a pelvic mesh sling. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 7 | pages= 917-21 | pmid=7931970 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7931970 }}</ref> | ||
Revision as of 07:16, 18 June 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Primary prevention of radiation proctitis can be done by the modifications of radiation techniques and doses or by use of prophylactic adjunct medical and surgical therapies.
Primary Prevention
Primary prevention strategies include: [1]
- modifications of radiation techniques and doses (Ex: intensity-modulated radiation therapy, image-guided radiation therapy decreases the rectal toxicity while maximizing the dose to the tumor.)[2]
- Identifying high risk patients, based on genomic study helps taking extra precautions in those patients[3][4]
- Use of adjuvant medical treatment (Ex: amifostine, sucralfate, 5-aminosalicylic acid, or sulphasalazine) have been associated with the minimal effect and are rarely used.[5][6][7]
- Synbiotics and microbiotics can be used to prevent radiation proctitis by altering the intestinal flora.[8][9]
- Implantation of of endorectal balloons and novel rectum spacers lead to reduction in the maximum dose to the rectum and the total volume of irradiated rectum[10]
- Prophylactic surgical therapies in the form of insertion of biodegradable mesh slings, intra-pelvic breast prostheses or omentoplasty can be done during operative resection,whenever postoperative radiotherapy may be indicated.[11]
References
- ↑ Hille A, Christiansen H, Pradier O, Hermann RM, Siekmeyer B, Weiss E; et al. (2005). "Effect of pentoxifylline and tocopherol on radiation proctitis/enteritis". Strahlenther Onkol. 181 (9): 606–14. doi:10.1007/s00066-005-1390-y. PMID 16170489.
- ↑ Fonteyne V, De Neve W, Villeirs G, De Wagter C, De Meerleer G (2007). "Late radiotherapy-induced lower intestinal toxicity (RILIT) of intensity-modulated radiotherapy for prostate cancer: the need for adapting toxicity scales and the appearance of the sigmoid colon as co-responsible organ for lower intestinal toxicity". Radiother Oncol. 84 (2): 156–63. doi:10.1016/j.radonc.2007.06.013. PMID 17692976.
- ↑ Fachal L, Gómez-Caamaño A, Barnett GC, Peleteiro P, Carballo AM, Calvo-Crespo P; et al. (2014). "A three-stage genome-wide association study identifies a susceptibility locus for late radiotherapy toxicity at 2q24.1". Nat Genet. 46 (8): 891–4. doi:10.1038/ng.3020. PMID 24974847.
- ↑ West CM, Barnett GC (2011). "Genetics and genomics of radiotherapy toxicity: towards prediction". Genome Med. 3 (8): 52. doi:10.1186/gm268. PMC 3238178. PMID 21861849.
- ↑ Stellamans K, Lievens Y, Lambin P, Van den Weyngaert D, Van den Bogaert W, Scalliet P; et al. (2002). "Does sucralfate reduce early side effects of pelvic radiation? A double-blind randomized trial". Radiother Oncol. 65 (2): 105–8. PMID 12443806.
- ↑ Simone NL, Ménard C, Soule BP, Albert PS, Guion P, Smith S; et al. (2008). "Intrarectal amifostine during external beam radiation therapy for prostate cancer produces significant improvements in Quality of Life measured by EPIC score". Int J Radiat Oncol Biol Phys. 70 (1): 90–5. doi:10.1016/j.ijrobp.2007.05.057. PMC 2267374. PMID 17855015.
- ↑ Koukourakis MI, Kyrgias G, Panteliadou M, Papadopoulou A, Tsiarkatsi M, Papachristou E; et al. (2013). "Dose escalation of amifostine for radioprotection during pelvic accelerated radiotherapy". Am J Clin Oncol. 36 (4): 338–43. doi:10.1097/COC.0b013e318248d882. PMID 22643562.
- ↑ Ferreira MR, Muls A, Dearnaley DP, Andreyev HJ (2014). "Microbiota and radiation-induced bowel toxicity: lessons from inflammatory bowel disease for the radiation oncologist". Lancet Oncol. 15 (3): e139–47. doi:10.1016/S1470-2045(13)70504-7. PMID 24599929.
- ↑ Nascimento M, Aguilar-Nascimento JE, Caporossi C, Castro-Barcellos HM, Motta RT (2014). "Efficacy of synbiotics to reduce acute radiation proctitis symptoms and improve quality of life: a randomized, double-blind, placebo-controlled pilot trial". Int J Radiat Oncol Biol Phys. 90 (2): 289–95. doi:10.1016/j.ijrobp.2014.05.049. PMID 25304789.
- ↑ Smeenk RJ, van Lin EN (2013). "Application of anorectal sparing devices in prostate radiotherapy". Radiother Oncol. 106 (2): 155–6. doi:10.1016/j.radonc.2013.02.004. PMID 23474285.
- ↑ Meric F, Hirschl RB, Mahboubi S, Womer RB, Goldwein J, Ross AJ; et al. (1994). "Prevention of radiation enteritis in children, using a pelvic mesh sling". J Pediatr Surg. 29 (7): 917–21. PMID 7931970.