Late gastrointestinal toxicity after radiotherapy for rectal cancer: a systematic review

Sipaviciute, Agne; Sileika, Ernestas; Burneckis, Arvydas; Dulskas, Audrius

doi:10.1007/s00384-020-03595-x

Cited by 33 publications

(30 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More than just the single variables of symptom burden, distress, and HRQOL, the interactions found between these variables are important. First, the results revealed a strong correlation between LRTI symptoms and HRQOL, confirming previous research on symptom burden as a risk factor for impaired HRQOL [ 6 , 11 , 24 – 26 ]. It is worrisome that these patients often are underdiagnosed and undertreated, although the symptom burden severely impairs HRQOL [ 2 , 7 ].…”

Section: Discussionsupporting

confidence: 86%

“…Radiotherapy is an important part of the multimodal curative treatment for pelvic cancers. However, as radiation also affects normal tissue, it may lead to radiation tissue injuries that can increase or persist for a long time and are often severe [2][3][4][5][6]. Adverse effects of radiotherapy on normal tissue leave approximately 5-15% of patients with late radiation tissue injuries (LRTIs) [7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Symptom burden, psychological distress, and health-related quality of life in cancer survivors with pelvic late radiation tissue injuries

Velure

Müller

Hauken

2021

Support Care Cancer

View full text Add to dashboard Cite

Purpose Curative radiotherapy for cancer may lead to severe late radiation tissue injuries (LRTIs). However, limited knowledge exists about pelvic cancer survivors’ LRTI symptoms, distress, and health-related quality of life (HRQOL). We sought to assess the symptom burden, distress, and HRQOL in survivors with established pelvic LRTIs compared to norm populations and to investigate the relation between these factors. Methods Cancer survivors referred for treatment of established pelvic LRTIs were recruited nationwide. LTRIs were assessed with the Expanded Prostate Cancer Index Composite (EPIC), psychological distress was assessed with the General Health Questionnaire (GHQ-12), and HRQOL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORCT-QLQ-C30). Results A total of 107 participants (mean age 64, 53% men) were included. Compared to norms, participants reported more urinary (mean 68.7 vs. 89.5; p = 0.00; d = 1.4) and bowel symptoms (mean 62.5 vs. 92.4; p = 0.00; d = 2.7), increased psychological distress (mean 13.4 vs. 10.3; p = 0.00; d = 0.6), and overall poorer HRQOL (mean 54.9 vs. 71.2; p = 0.00; d = 0.7). Higher symptom burden and higher levels of psychological distress were associated with lower HRQOL (r2 = 46%), but psychological distress did not moderate the influence of symptoms on HRQOL. Conclusion Cancer survivors with established pelvic LRTIs are highly burdened compared to norms. The association of the LRTI-related symptom burden with HRQOL is independent of the level of psychological distress. Both coping and treatment interventions are crucial to promoting long-term health and HRQOL. Trial registration NCT03570229.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Symptom burden, psychological distress, and health-related quality of life in cancer survivors with pelvic late radiation tissue injuries

Velure

Müller

Hauken

2021

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…Chemoradiotherapy has a significant negative effect and may lead to a spectrum of acute and late toxicities such as ulceration, bleeding, diarrhea, or problems of the skin. According to literature, 30-40% of the patients had chronic diarrhea, about 15% of the patients had obstructions, and even half of the patients had anorectal dysfunction after chemoradiotherapy (23)(24)(25). However, chemoradiotherapy is improving in areas warranting future research, such as advanced chemoradiation delivery techniques and risk-stratified patient management approaches are evolving and hopefully, it will cause a less negative effect in the future.…”

Section: Discussionmentioning

confidence: 99%

Local Excision ± Chemoradiotherapy vs. Total Mesorectal Excision for Early Rectal Cancer: Case-Matched Analysis of Long-Term Results

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Our aim was to compare the bowel function and oncologic outcomes following these two treatment modalities.Materials and methods: This was a single-center study with 67 patients included between 2009 and 2018. A total of 32 patients underwent total mesorectal excision (TME) group and 35 transanal local excisions (LE) ± chemoradiation. We performed a case-matched analysis: we matched the patients by age, cancer stage, and comorbidities. Duration of operation, postoperative complications, length of hospital stay, and long-term functional and oncological outcomes were compared. We calculated oncological outcomes using Kaplan–Meier Cox diagrams. In addition, we used a low anterior resection syndrome (LARS) score for the bowel function assessment.Results: Mean operation time in the LE group was 58.8 ± 45 min compared with the TME group that was 121.1 ± 42 min (p = 0.032). Complications were seen in 5.7% in LE group and 15.62% in TME group (p = 0.043). ~85.2% of the patients had no LARS in LE group compared with 54.5% in TME group (p = 0.018). Minor LARS was 7.4% in LE group compared with 31.8% in TME group (p = 0.018); major LARS was 7.4 and 13.7%, respectively (p = 0.474). Hospital stay was 2.77 days in LE group compared with 9.21 days in TME group (p = 0.036). The overall survival was 68.78 months in LE group compared with 74.81 months in TME group (p = 0.964).Conclusion: Our results of a small sample size showed that local excision ± chemoradiation is a rather safe method for early rectal cancer compared with gold standard treatment. In addition, better bowel function is preserved with less postoperative complications and shorter hospital stays.

show abstract

“…Radiotherapy is an important treatment strategy for several malignancies including lung cancer, prostate cancer, and renal cell carcinoma. However, despite significant improvements in radiotherapy delivery methods, incidence of irradiation induced bowel disease is a huge challenge for clinical, exposure to radiation causes lesions, which can result in several complications such as hematopoietic and gastrointestinal dysfunction and death ( Seong, 2009 ; Hazell et al, 2020 ; Miccio et al, 2020 ; Sipaviciute et al, 2020 ; Molitoris et al, 2021 ). The small intestine is a highly radiosensitive organ, and radiation-induced enteropathy (RIE) tends to emerge quickly after radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

Autophagy Induced by Micheliolide Alleviates Acute Irradiation-Induced Intestinal Injury via Inhibition of the NLRP3 Inflammasome

Shen

Jin

et al. 2022

Front. Pharmacol.

View full text Add to dashboard Cite

Radiation-induced enteropathy (RIE) is one of the most common and fatal complications of abdominal radiotherapy, with no effective interventions available. Pyroptosis, a form of proinflammatory regulated cell death, was recently found to play a vital role in radiation-induced inflammation and may represent a novel therapeutic target for RIE. To investigate this, we found that micheliolide (MCL) exerted anti-radiation effects in vitro. Therefore, we investigated both the therapeutic effects of MCL in RIE and the possible mechanisms by which it may be therapeutic. We developed a mouse model of RIE by exposing C57BL/6J mice to abdominal irradiation. MCL treatment significantly ameliorated radiation-induced intestinal tissue damage, inflammatory cell infiltration, and proinflammatory cytokine release. In agreement with these observations, the beneficial effects of MCL treatment in RIE were abolished in Becn1+/− mice. Furthermore, super-resolution microscopy revealed a close association between NLR pyrin domain three and lysosome-associated membrane protein/light chain 3-positive vesicles following MCL treatment, suggesting that MCL facilitates phagocytosis of the NLR pyrin domain three inflammasome. In summary, MCL-mediated induction of autophagy can ameliorate RIE by NLR pyrin domain three inflammasome degradation and identify MCL as a novel therapy for RIE.

show abstract

Late gastrointestinal toxicity after radiotherapy for rectal cancer: a systematic review

Cited by 33 publications

References 19 publications

Symptom burden, psychological distress, and health-related quality of life in cancer survivors with pelvic late radiation tissue injuries

Symptom burden, psychological distress, and health-related quality of life in cancer survivors with pelvic late radiation tissue injuries

Local Excision ± Chemoradiotherapy vs. Total Mesorectal Excision for Early Rectal Cancer: Case-Matched Analysis of Long-Term Results

Autophagy Induced by Micheliolide Alleviates Acute Irradiation-Induced Intestinal Injury via Inhibition of the NLRP3 Inflammasome

Contact Info

Product

Resources

About