The Efficacy of the Combination Therapy with Oral and Topical Mesalazine for Patients with the First Episode of Radiation Proctitis

Seo, Eun Hee; Kim, Tae Oh; Joo, Hee Rin; Park, Jongha; Park, Seung Ha; Yang, Sung Bong; Moon, Young Soo; Park, Min Jae; Ryu, Dong Yup; Song, Geun Am

doi:10.1007/s10620-011-1637-7

Cited by 19 publications

(18 citation statements)

References 26 publications

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“…However, radiotherapy techniques have completely changed since the 70 s, thus the results of the above mentioned trial might not be suitable to present day. One prospective study assessed the efficacy of combined oral and topical mesalazine in 23 patients with chronic PRD, and found that mesalazine significantly improved rectal bleeding, but not other radiation-related symptoms (i.e., pain, tenesmus and stool frequency) after 4 wk of treatment [41] . Current evidence does not support mesalazine routine use for the treatment of acute nor chronic PRD.…”

Section: Aminosalicylatesmentioning

confidence: 99%

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Pelvic radiation disease: Updates on treatment options

Frazzoni

Marca

Guido

et al. 2015

WJCO

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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 radiationtreated 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 longterm, 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.

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Section: Aminosalicylatesmentioning

confidence: 99%

“…Current evidence does not support mesalazine routine use for the treatment of acute nor chronic PRD. However, a 4 wk treatment of mesalazine, once daily as a 1 g rectal suspension, might be considered in patients referred for chronic rectal bleeding developed after radiation treatment, as second-line therapy [41] .…”

Section: Aminosalicylatesmentioning

confidence: 99%

Pelvic radiation disease: Updates on treatment options

Frazzoni

Marca

Guido

et al. 2015

WJCO

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“…A recent study on 23 patients with CRP showed a decrease in bleeding with a combination of oral and topical mesalamine [Kochhar et al 1991]. A small, randomized clinical trial showed clinical and endoscopic improvement with a combination of oral sulfasalazine and rectal prednisolone [Seo et al 2011].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation for the treatment of radiation proctitis: a case report and review of literature

Eddi

DePasquale

2012

Therap Adv Gastroenterol

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Radiation proctitis is a frequent complication of pelvic radiation for cancer. This condition can present acutely within several weeks of radiation, or chronically many months or years after radiation, leading to rectal bleeding and transfusion-dependent anemia. Various medical and endoscopic therapies have been described to treat this condition; however, some patients fail to respond to the current standard therapies. Here we present a case of refractory radiation proctitis, with suboptimal response to other therapies, treated successfully with a novel method, radiofrequency ablation.

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“…Seo et al 28 reported on a trial employing mesalazine, a mainstay of treatment for ulcerative colitis, to treat 23 patients. Three patients required APC for severe bleeding and were excluded from the trial, leaving 20 evaluable patients.…”

Section: Topical Agentsmentioning

confidence: 99%

Management of Radiation Proctitis

Mendenhall

McKibben²,

Hoppe³

et al. 2014

American Journal of Clinical Oncology

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The optimal management of radiation proctitis is ill defined. A variety of alternatives are available and include topical agents (ie, sucralfate enemas, formalin), oral agents (ie, pentoxyfylline, vitamin A), hyperbaric oxygen, and endoscopic interventions (ie, argon plasma coagulation). It is prudent to manage patients conservatively and to intervene only when necessary with the option least likely to exacerbate the proctitis. Rectal biopsies should be avoided as they may precipitate a complication. More aggressive measures, such as argon laser coagulation, should be employed only when more conservative approaches fail.

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The Efficacy of the Combination Therapy with Oral and Topical Mesalazine for Patients with the First Episode of Radiation Proctitis

Abstract: The combination of oral and topical mesalazine therapy for radiation proctitis may be a safe and effective treatment for naive radiation proctitis, especially for hemorrhagic proctitis. A large, randomized controlled trial is required to confirm the results of this pilot study.

Cited by 19 publications

References 26 publications

Pelvic radiation disease: Updates on treatment options

Pelvic radiation disease: Updates on treatment options

Radiofrequency ablation for the treatment of radiation proctitis: a case report and review of literature

Management of Radiation Proctitis

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