Intra-Arterial Epinephrine Protection Against Radiation Nephritis

Steckel, Richard J.; Tobin, Peter; Stein, Joshua; Bennett, Rick

doi:10.1148/92.6.1341

Cited by 10 publications

(3 citation statements)

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“…18 Steckel et al. 19 observed that intra-arterial infusion of epinephrine prevents radiation-induced nephritis in an animal model. Gao et al20 reported that topical use of epinephrine on the skin and oral mucosa significantly reduces radiation-induced damage in a mice model.Altogether, the results of the above preclinical studies have suggested that epinephrine might be an effective radio-protective agent.…”

Section: Introductionmentioning

confidence: 97%

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<p>Intra-rectal use of epinephrine in radiotherapy of prostate cancer</p>

Qin

Gao

et al. 2019

CMAR

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Purpose: The aim of the study was to evaluate the feasibility and toxicity of intra-rectal epinephrine during prostatic radiotherapy. Materials and methods: A total of 34 patients with prostate cancer were randomized to receive daily intra-rectal epinephrine (4 mg in 40 mL, n=16) or placebo (40 mL normal saline, n=18) 5 min before daily radiotherapy. Physical examination including systolic blood pressure (SBP) and heart rate (HR) was performed before, 5 min after, and 20 min after intra-rectal use. Toxicities were graded using the Radiation Therapy Oncology Group standard. A two-sided Fisher's exact test was used to compare proportions between groups. A mixed-effects model was used to analyze multiple measurements of SBP and HR. Survival curves were calculated using the Kaplan–Meier method and compared between groups using the log-rank test. Results: All patients completed the protocol treatment and reported no cardiovascular symptoms after intra-rectal administration. There were no differences in SBP and HR between these two groups at any time point (before, 5 min after, and 20 min after epinephrine). At 5 weeks after the start of radiotherapy, the incidence of rectal toxicity≥grade 2 was 27.8% (5/18) for the control group versus 12.5% (2/16) for the epinephrine group, but was not statistically significant ( p =0.4). There was no rectal toxicity≥grade 2 in these two groups beyond 2-year follow-up. The 5-year biochemical relapse-free survival was 75.0% and 72.2% for the epinephrine and control group, respectively. Conclusion: Results of this pilot randomized trial have demonstrated that intra-rectal administration of epinephrine is feasible and safe in prostatic radiotherapy. Its radio-protective effect warrants further investigation.

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Section: Introductionmentioning

confidence: 97%

“…The authors believed that epinephrine might reduce blood flow in the spinal cord and improve the anoxic environment in the spinal cord, which relieves radiation damage. 18 Steckel et al. 19 observed that intra-arterial infusion of epinephrine prevents radiation-induced nephritis in an animal model.…”

Section: Introductionmentioning

confidence: 99%

<p>Intra-rectal use of epinephrine in radiotherapy of prostate cancer</p>

Qin

Gao

et al. 2019

CMAR

View full text Add to dashboard Cite

show abstract

“…The advantage of reducing the radiation sensitivity of the intestine during treatment of abdominal tumors is obvious and has been the subject of increasing interest (1, 4, 7, 8,10,12). These investigations have not yet achieved their goal, a treatment model directly applicable in man.…”

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confidence: 99%