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Chronic radiation proctitis: tricks to prevent and treat

OBJECTIVE: The purpose of this study was to give an overview of the measures used to prevent chronic radiation proctitis (CRP) and to provide an algorithm for the treatment of CRP. METHODS: Medical literature databases including PubMed and Medline were screened and critically analyzed for relevance...

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Autores principales: Vanneste, Ben G. L., Van De Voorde, Lien, de Ridder, Rogier J., Van Limbergen, Evert J., Lambin, Philippe, van Lin, Emile N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575375/
https://www.ncbi.nlm.nih.gov/pubmed/26198994
http://dx.doi.org/10.1007/s00384-015-2289-4
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author Vanneste, Ben G. L.
Van De Voorde, Lien
de Ridder, Rogier J.
Van Limbergen, Evert J.
Lambin, Philippe
van Lin, Emile N.
author_facet Vanneste, Ben G. L.
Van De Voorde, Lien
de Ridder, Rogier J.
Van Limbergen, Evert J.
Lambin, Philippe
van Lin, Emile N.
author_sort Vanneste, Ben G. L.
collection PubMed
description OBJECTIVE: The purpose of this study was to give an overview of the measures used to prevent chronic radiation proctitis (CRP) and to provide an algorithm for the treatment of CRP. METHODS: Medical literature databases including PubMed and Medline were screened and critically analyzed for relevance in the scope of our purpose. RESULTS: CRP is a relatively frequent late side effect (5–20%) and mainly dependent on the dose and volume of irradiated rectum. Radiation treatment (RT) techniques to prevent CRP are constantly improving thanks to image-guided RT and intensity-modulated RT. Also, newer techniques like protons and new devices such as rectum spacers and balloons have been developed to spare rectal structures. Biopsies do not contribute to diagnosing CRP and should be avoided because of the risk of severe rectal wall damage, such as necrosis and fistulas. There is no consensus on the optimal treatment of CRP. A variety of possibilities is available and includes topical and oral agents, hyperbaric oxygen therapy, and endoscopic interventions. CONCLUSIONS: CRP has a natural history of improving over time, even without treatment. This is important to take into account when considering these treatments: first be conservative (topical and oral agents) and be aware that invasive treatments can be very toxic.
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spelling pubmed-45753752015-09-23 Chronic radiation proctitis: tricks to prevent and treat Vanneste, Ben G. L. Van De Voorde, Lien de Ridder, Rogier J. Van Limbergen, Evert J. Lambin, Philippe van Lin, Emile N. Int J Colorectal Dis Review OBJECTIVE: The purpose of this study was to give an overview of the measures used to prevent chronic radiation proctitis (CRP) and to provide an algorithm for the treatment of CRP. METHODS: Medical literature databases including PubMed and Medline were screened and critically analyzed for relevance in the scope of our purpose. RESULTS: CRP is a relatively frequent late side effect (5–20%) and mainly dependent on the dose and volume of irradiated rectum. Radiation treatment (RT) techniques to prevent CRP are constantly improving thanks to image-guided RT and intensity-modulated RT. Also, newer techniques like protons and new devices such as rectum spacers and balloons have been developed to spare rectal structures. Biopsies do not contribute to diagnosing CRP and should be avoided because of the risk of severe rectal wall damage, such as necrosis and fistulas. There is no consensus on the optimal treatment of CRP. A variety of possibilities is available and includes topical and oral agents, hyperbaric oxygen therapy, and endoscopic interventions. CONCLUSIONS: CRP has a natural history of improving over time, even without treatment. This is important to take into account when considering these treatments: first be conservative (topical and oral agents) and be aware that invasive treatments can be very toxic. Springer Berlin Heidelberg 2015-07-23 2015 /pmc/articles/PMC4575375/ /pubmed/26198994 http://dx.doi.org/10.1007/s00384-015-2289-4 Text en © The Author(s) 2015 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Vanneste, Ben G. L.
Van De Voorde, Lien
de Ridder, Rogier J.
Van Limbergen, Evert J.
Lambin, Philippe
van Lin, Emile N.
Chronic radiation proctitis: tricks to prevent and treat
title Chronic radiation proctitis: tricks to prevent and treat
title_full Chronic radiation proctitis: tricks to prevent and treat
title_fullStr Chronic radiation proctitis: tricks to prevent and treat
title_full_unstemmed Chronic radiation proctitis: tricks to prevent and treat
title_short Chronic radiation proctitis: tricks to prevent and treat
title_sort chronic radiation proctitis: tricks to prevent and treat
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575375/
https://www.ncbi.nlm.nih.gov/pubmed/26198994
http://dx.doi.org/10.1007/s00384-015-2289-4
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