Late-onset Bowel Dysfunction after Pelvic Radiotherapy: A National Survey of Current Practice and Opinions of Clinical Oncologists

Henson, Caroline C; Andreyev, H. J. N.; Symonds, R.P.; Peel, David; Swindell, Ric; Davidson, Susan E

doi:10.1016/j.clon.2011.04.002

Cited by 38 publications

(16 citation statements)

References 13 publications

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“…In agreement with our findings, Henson et al showed that late-onset bowel dysfunction can pose a significant problem after pelvic radiotherapy, emphasizing that clinical oncologists be aware of such possibilities. 11 In our study, patients with late-onset complications demonstrated poorer complication resolution outcomes. In contrast, Zucali et al reported that the side effects of radiotherapy were moderate and transient and that no late-onset small bowel complications were observed; however, the follow-up period in that study was ,10 years.…”

Section: Discussionmentioning

confidence: 71%

Complications Associated With Postoperative Adjuvant Radiation Therapy for Advanced Rectal Cancer

Kono

Kimura

Kinoshita

et al. 2014

International Surgery

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Preoperative management of advanced rectal cancer often includes chemoradiotherapy, but little is known about the late complications of radiotherapy. However, these are usually serious, making determination of the characteristics of late complications after radiation therapy critical. Accordingly, we investigated the complications occurring after adjuvant pelvic radiation therapy in patients with advanced rectal cancer. We enrolled 34 consecutive patients with TNM stage III rectal cancer who had undergone curative surgery with adjuvant pelvic radiation therapy. Data on the type of complication/organ involved, the number of complications, the phase of onset, and the treatments used were reviewed. Patients who experienced gut complications or edema were less likely to have their complications resolved than those with complications due to infection. Similarly, patients with multiple complications and late-onset complications were also less likely to have their complications resolved than those with single complications and those with early-onset complications, respectively. Adjuvant radiation therapy in patients with resected advanced rectal cancer was associated with various complications, characterized by late onset and impaired resolution. Therefore, patients indicated for radiation therapy should be selected with great caution.

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Section: Discussionmentioning

confidence: 71%

Complications Associated With Postoperative Adjuvant Radiation Therapy for Advanced Rectal Cancer

Kono

Kimura

Kinoshita

et al. 2014

International Surgery

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“…A recent national survey of U.K. Clinical Oncologists established that although late adverse effects following pelvic radiotherapy are gradually being recognised, there is a lack of specialist services for patients with late-onset bowel dysfunction (Henson et al, 2011). As cancer treatments evolve and we learn more about the risk factors associated with the consequences of treatment there is a need for more individually targeted follow-up and support.…”

Section: Discussionmentioning

confidence: 97%

Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life

Knowles

Haigh

McLean

et al. 2013

European Journal of Oncology Nursing

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“…It is estimated that in the United States, w300,000 patients/y receive radiotherapy for pelvic or abdominal malignancies (1,2). In the United Kingdom, an estimated 17,000 patients/y receive radical (curative) radiotherapy (3). Despite major advances in radiotherapy techniques, radiation-induced gastrointestinal toxicity is common.…”

Section: Introductionmentioning

confidence: 99%

Randomized controlled trial of dietary fiber for the prevention of radiation-induced gastrointestinal toxicity during pelvic radiotherapy

Wedlake

Shaw

McNair

et al. 2017

The American Journal of Clinical Nutrition

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Background: Therapeutic radiotherapy is an important treatment of pelvic cancers. Historically, low-fiber diets have been recommended despite a lack of evidence and potentially beneficial mechanisms of fiber.Objective: This randomized controlled trial compared low-, habitual-, and high-fiber diets for the prevention of gastrointestinal toxicity in patients undergoing pelvic radiotherapy. Design: Patients were randomly assigned to low-fiber [#10 g nonstarch polysaccharide (NSP)/d], habitual-fiber (control), or high-fiber ($18 g NSP/d) diets and received individualized counseling at the start of radiotherapy to achieve these targets. The primary endpoint was the difference between groups in the change in the Inflammatory Bowel Disease QuestionnaireBowel Subset (IBDQ-B) score between the starting and nadir (worst) score during treatment. Other measures included macronutrient intake, stool diaries, and fecal short-chain fatty acid concentrations. Results: Patients were randomly assigned to low-fiber (n = 55), habitual-fiber (n = 55), or high-fiber (n = 56) dietary advice. Fiber intakes were significantly different between groups (P , 0.001). The difference between groups in the change in IBDQ-B scores between the start and nadir was not significant (P = 0.093). However, the change in score between the start and end of radiotherapy was smaller in the high-fiber group (mean 6 SD: 23.7 6 12.8) than in the habitual-fiber group (210.8 6 13.5; P = 0.011). At 1-y postradiotherapy (n = 126) the difference in IBDQ-B scores between the high-fiber (+0.1 6 14.5) and the habitualfiber (28.4 6 13.3) groups was significant (P = 0.004). No significant differences were observed in stool frequency or form or in short-chain fatty acid concentrations. Significant reductions in energy, protein, and fat intake occurred in the low-and habitualfiber groups only. Conclusions: Dietary advice to follow a high-fiber diet during pelvic radiotherapy resulted in reduced gastrointestinal toxicity both acutely and at 1 y compared with habitual-fiber intake. Restrictive, non-evidence-based advice to reduce fiber intake in this setting should be abandoned. This trial was registered at clinicaltrials.gov as NCT 01170299.Am J Clin Nutr doi: https://doi.org/10.3945/ajcn.116.150565.

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Late-onset Bowel Dysfunction after Pelvic Radiotherapy: A National Survey of Current Practice and Opinions of Clinical Oncologists

Cited by 38 publications

References 13 publications

Complications Associated With Postoperative Adjuvant Radiation Therapy for Advanced Rectal Cancer

Complications Associated With Postoperative Adjuvant Radiation Therapy for Advanced Rectal Cancer

Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life

Randomized controlled trial of dietary fiber for the prevention of radiation-induced gastrointestinal toxicity during pelvic radiotherapy

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