Radiation proctitis primary prevention
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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.[1]
Primary Prevention
Primary prevention strategies include: [2]
- 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.)[3]
- Identifying high risk patients, based on genomic study helps taking extra precautions in those patients[4][5]
- Use of adjuvant medical treatment (Ex: amifostine, sucralfate, 5-aminosalicylic acid, or sulphasalazine) have been associated with the minimal effect and are rarely used.[6][7][8]
- Synbiotics and microbiotics can be used to prevent radiation proctitis by altering the intestinal flora.[9][10]
- 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[11]
- 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.[12]
References
- ↑ Babb RR (1996). "Radiation proctitis: a review". Am J Gastroenterol. 91 (7): 1309–11. PMID 8677984.
- ↑ 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.