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2015 ; 6
(6
): 272-80
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Pelvic radiation disease: Updates on treatment options
#MMPMID26677440
Frazzoni L
; La Marca M
; Guido A
; Morganti AG
; Bazzoli F
; Fuccio L
World J Clin Oncol
2015[Dec]; 6
(6
): 272-80
PMID26677440
show ga
Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy
represents one of the main treatment options. The irradiation field usually
encompasses healthy intestinal tissue, especially of distal large bowel, thus
inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of
radiation-treated patients say that their quality of life is affected by GI
symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms -
from transient to long-term, from mild to very severe - experienced by patients
who underwent radiation treatment for a pelvic tumor have been comprised in the
definition of pelvic radiation disease (PRD). A correct and evidence-based
therapeutic approach of patients experiencing GI radiation-induced toxicity is
mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two
broad categories, i.e., medical and endoscopic. Of note, most of the studies have
investigated the management of radiation-induced rectal bleeding. Patients with
clinically significant bleeding (i.e., causing chronic anemia) should firstly be
considered for medical management (i.e., sucralfate enemas, metronidazole and
hyperbaric oxygen); in case of failure, endoscopic treatment should be
implemented. This latter should be considered the first choice in case of acute,
transfusion requiring, bleeding. More well-performed, high quality studies should
be performed, especially the role of medical treatments should be better
investigated as well as the comparative studies between endoscopic and hyperbaric
oxygen treatments.