Sucralfate versus Mesalazine versus Hydrocortisone in the Prevention of Acute Radiation Proctitis during Conformal Radiotherapy for Prostate Carcinoma

Sanguineti, Giuseppe; Franzone, P.; Marcenaro, Michela; Foppiano, F.; Vitale, Vito

doi:10.1007/s00066-003-1082-4

Cited by 61 publications

(26 citation statements)

References 31 publications

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“…Numerous studies have been performed to prevent acute and late rectal toxicity, but till now, medical prevention of proctitis remains unsatisfactory [2,3,15,20,22,30,33,36,37,39]. In animal models, systematically as well as topically administered misoprostol has been shown to protect against radiation-induced mucosa injury of the small bowel [5, 9-12, 14, 31].…”

Section: Medical Prevention Of Radiationinduced Late Rectal Toxicitymentioning

confidence: 99%

“…Though an association between acute and late toxicity remains controversial, some previously published reports discussed that there might be a correlation between both [34,42,44]. Numerous different drugs for the prevention and treatment of radiation-induced rectal toxicity are available [2,3,15,20,22,30,33,36,37,39], but effective medicals for both treatment and prevention remain unsatisfactory [2,3,15,20,22,25,27,30,33,36,37,39]. One randomized study indicated that misoprostol suppositories might prevent acute and late radiation-induced proctitis [19].…”

Section: Introductionmentioning

confidence: 99%

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Effect of a Prostaglandin – Given Rectally for Prevention of Radiation-Induced Acute Proctitis – on Late Rectal Toxicity

et al. 2009

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Background and Purpose:To assess the late effect of a prostaglandin, given rectally during irradiation, on late rectal toxicity. In the acute treatment setting no significant differences in reducing the incidence of acute proctitis symptoms in patients receiving misoprostol, however, significantly more rectal bleeding had been reported. Patients and Methods: A total of 100 patients who had undergone radiotherapy for prostate cancer had been entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. The toxicity was evaluated yearly after cessation of irradiation by the RTOG/LENT-SOMA scale. Results: The median follow-up was 50 months. 20 patients suffered from grade 1, four patients from grade 2 as well, and three patients only from grade 2 toxicity. Frequency, bleeding and urgency were the most commonly reported symptoms. In keeping with other studies and clinical experience, the symptoms peaked within the first 2 years with a median for grade 1 of 13 months and for grade 2 of 15 months. The presence of acute toxicity grade 2 showed a correlation with the development of any late toxicity (p = 0.03). Any acute rectal bleeding was significant correlated with any late rectal bleeding (p = 0.017). Conclusion: Misoprostol given as once-daily suppository for prevention of acute radiation-induced proctitis does neither influence the incidence and severity of radiation-induced acute nor late rectal toxicity. Misoprostol has no negative impact on the incidence and severity of late rectal bleeding, in contrast to acute rectal bleeding. The routine clinical use of misoprostol suppositories cannot be recommended. Effekt eines Prostaglandins -rektal gegeben zur Prävention von radiotherapieinduzierter akuter Proktitis -auf die späte rektale Toxizität. Ergebnisse einer randomisierten, plazebokontrollierten, doppelblinden Phase-III-StudieHintergrund und Ziel: Diese Untersuchung wurde durchgeführt, um einen potentiellen Einfluss von zur Prophylaxe der akuten Proktitis rektal gegebenem Misoprostol auf radiogene rektale Spätreaktionen zu evaluieren. Patienten und Methodik: 100 Patienten, die mit Radiotherapie bei Prostatakarzinom behandelt wurden, wurden in diese randomisierte, plazebokontrollierte, doppelblinde Phase-III-Studie mit Misoprostol-bzw. Plazebozäpfchen eingeschlossen. Die Toxizität wurde jährlich anhand der RTOG-und LENT-SOMA-Skalen erhoben. Ergebnisse: Der mediane Nachbeobachtungszeitraum betrug 50 Monate. Bei 20 Patienten trat eine Grad-1-, bei vier ebenfalls eine Grad-2-und bei drei Patienten nur eine Grad-2-Toxizität auf. Frequenz, Blutung und Stuhldrang waren die häufigsten Symptome. Vergleichbar mit anderen Studien und klinischer Erfahrung, traten die Symptome am häufigs-ten innerhalb der ersten 2 Jahre mit einer medianen Zeit von 13 Monaten für Grad-1-und 15 Monaten für Grad-2-Proktitis auf. Das Vorhandensein akuter Grad-2-Toxizität zeigte eine Korrelation mit der Entwicklung von später Toxizität (p = 0,03). Akute Blutung war signifikant korreliert ...

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Section: Medical Prevention Of Radiationinduced Late Rectal Toxicitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of a Prostaglandin – Given Rectally for Prevention of Radiation-Induced Acute Proctitis – on Late Rectal Toxicity

et al. 2009

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“…Auch in unserem Patientengut litten 38% unter Nebenwirkungen Grad III und IV (nach WHO). Häufigste Nebenwirkung und Gegenstand intensivster Untersuchungen [24] ist die Proktitis. Auch bei unseren Patienten stellte die mit einer Proktitis assoziierte Diarrhö die wichtigste Nebenwirkung dar.…”

Section: Diskussionunclassified

Einfluss einer präoperativen (hyperthermen) Radiochemotherapie auf die manometrisch erfasste Analsphinkterfunktion beim lokal fortgeschrittenen Rektumkarzinom

et al. 2004

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“…The normal tissues most relevent to radiation toxicity typically contain epithelial cells with high rates of turnover including the lining of the gastrointestinal tract and the skin. Existing radiation protectors including the FDA-approved amifostine (Brizel, 2007), sucralfate (Hovdenak et al, 2005), and mesalazine (Sanguineti et al, 2003) are of limited utility in protecting these normal tissues against radiation effects primarily due to their own toxicity.…”

Section: Introductionmentioning

confidence: 99%

Radiation‐Induced Toxicity and Radiation Response Modifiers in Zebrafish

2011

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Sucralfate versus Mesalazine versus Hydrocortisone in the Prevention of Acute Radiation Proctitis during Conformal Radiotherapy for Prostate Carcinoma

Abstract: Topical mesalazine is contraindicated during radiotherapy. Hydrocortisone enema is not superior to sucralfate in preventing acute rectal toxicity.

Cited by 61 publications

References 31 publications

Effect of a Prostaglandin – Given Rectally for Prevention of Radiation-Induced Acute Proctitis – on Late Rectal Toxicity

Effect of a Prostaglandin – Given Rectally for Prevention of Radiation-Induced Acute Proctitis – on Late Rectal Toxicity

Einfluss einer präoperativen (hyperthermen) Radiochemotherapie auf die manometrisch erfasste Analsphinkterfunktion beim lokal fortgeschrittenen Rektumkarzinom

Radiation‐Induced Toxicity and Radiation Response Modifiers in Zebrafish

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