The incidence and clinical consequences of treatment-related bowel injury

Frequency and Surgical Management of Chronic Complications Related to Pelvic Radiation

“…20 The reported incidence of radiotherapy injuries following irradiation of pelvic neoplasms ranges between 5% and 40%. Miller et al, 9 in their series of 386 patients undergoing radiotherapy for rectal carcinoma, reported that 17% of patients developed clinically apparent radiotherapyinduced enteritis or proctitis, while Perez et al 21 reported an 8% incidence of moderate proctitis in patients undergoing radiotherapy for prostate cancer within 10 years. In his review on late radiation proctitis, Babb 22 reported incidence rates between 5% and 20% in patients treated for pelvic neoplasms.…”

“…7 Mortality directly related to pelvic or abdominal radiotherapy is difficult to assess in clinical studies, but most authors report mortality rates between 0% and 11%. [8][9][10] The intestine is an important doselimiting organ in abdominal and pelvic radiotherapy. Symptoms of acute radiation toxicity occur in most treated patients but are normally transient and resolve after completion of radiotherapy.…”

“…11 Delayed radiation enteropathy, though less frequent, typically presents 3 months to 6 years after radiotherapy and has been reported to occur in up to 40% of patients receiving abdominal or pelvic radiotherapy. 9,11 The incidence and severity of radiation enteropathy, however, depends on the dose of radiotherapy, the volume treated, fractionation schedule, and the length of followup. Additional risk factors include age, the presence of comorbidities, tobacco abuse, prior operation, and concurrent chemotherapy.…”

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

“…Auch bei unseren Patienten stellte die mit einer Proktitis assoziierte Diarrhö die wichtigste Nebenwirkung dar. Da eine radiogene Proktitis meist über das von uns eingehaltene Intervall zwischen RCT und Operation hinaus anhält [19], überprüften wir den Einfluss der Inflammation des Rektums auf die Sphinkterdrücke. Hierbei ließ sich kein stärkerer Abfall der Drücke in der Patientengruppe mit ausgeprägter Proktitis nachweisen, so dass davon auszugehen ist, dass die akute radiogene Proktitis nicht den entscheidenden Einfluss auf den Abfall der Sphinkterdrücke hat.…”

Effect of Pentoxifylline and Tocopherol on Radiation Proctitis/Enteritis

“…Bowel injuries result in fistulas, strictures, chronic malabsorption, abdominal cramping, and diarrhea. Significant bowel injury has been described to occur in up to 6% of patients receiving pelvic irradiation [9,13,21,29,46]. Radiation proctitis results in bleeding, pain, abdominal cramping, mucoid discharge, and fecal urgency; the incidence has been estimated between 5% and 30% after radiotherapy for prostate cancer [29].…”