Topical butyrate for acute radiation proctitis: randomised, crossover trial

Vernia, Piero; Fracasso, Pierluigi; Casale, V.; Villotti, G.; Marcheggiano, Adriana; Stigliano, V.; Pinnarò, Paola; Bagnardi, Vincenzo; Caprilli, R.

doi:10.1016/s0140-6736(00)02787-2

Cited by 121 publications

(58 citation statements)

References 12 publications

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“…The additional dilatation effect of SCFA on the arteriolar walls may improve mucosal blood flow [18,19]. Considering the limited published data, we decided to treat acute radiation-induced grade II proctitis with SCFA (sodium butyrate enemas) as it has been proven effective in a small number of patients [32]. Our study about treatment of radiation-induced proctitis grade II with sodium butyrate enemas confirmed the results shown by Vernia [32].…”

Section: Rectal Scfasupporting

confidence: 71%

“…But treatment of acute radiation-induced proctitis remains unsatisfactory. A double-blind randomized study with 20 patients showed an effect of topical sodium butyrate in the treatment of acute radiation-induced proctitis [32]. Thus, we evaluated prospectively the effect of sodium butyrate enemas on acute symptomatic proctitis in patients undergoing radiation therapy for prostate cancer and monitored these patients for late proctitis symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Sodium butyrate enemas in the treatment of acute radiation-induced proctitis in patients with prostate cancer and the impact on late proctitis

Hille¹,

Herrmann²,

Kertesz³

et al. 2008

Strahlenther Onkol

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Purpose:To evaluate prospectively the effect of sodium butyrate enemas on the treatment of acute and the potential influence on late radiation-induced proctitis. Patients and Methods: 31 patients had been treated with sodium butyrate enemas for radiation-induced acute grade II proctitis which had developed after 40 Gy in median. During irradiation the toxicity was evaluated weekly by the Common Toxicity Criteria (CTC) and subsequently yearly by the RTOG (Radiation Therapy Oncology Group) and LENT-SOMA scale. Results: 23 of 31 patients (74%) experienced a decrease of CTC grade within 8 days on median. A statistical significant difference between the incidence and the severity of proctitis before start of treatment with sodium butyrate enemas compared to 14 days later and compared to the end of irradiation treatment course, respectively, was found. The median follow-up was 50 months. Twenty patients were recorded as suffering from no late proctitis symptom. Eleven patients suffered from grade I and 2 of these patients from grade II toxicity, too. No correlation was seen between the efficacy of butyrate enemas on acute proctitis and prevention or development of late toxicity, respectively. Conclusion: Sodium butyrate enemas are effective in the treatment of acute radiation-induced proctitis in patients with prostate cancer but have no impact on the incidence and severity of late proctitis. Natriumbutyrat-Einläufe in der Behandlung der akuten radiotherapieinduzierten Proktitis bei Patienten mit Prostatakarzinom und der Einfluss auf eine späte Proktitis. Eine prospektive UntersuchungZiel: Diese prospektive Untersuchung wurde durchgeführt, um den Effekt von Natriumbutyrat-Einläufen in der Therapie der akuten Proktitis sowie den potentiellen Einfluss auf radiogene rektale Spätreaktionen zu evaluieren. Patienten und Methodik: 31 Patienten wurden mit Natriumbutyrat-Einläufen bei radiogen induzierter akuter Grad-II-Proktitis behandelt, die im Mittel nach 40 Gy aufgetreten war. Während der Radiotherapie wurde die Toxizität wöchentlich anhand der Common Toxicity Criteria (CTC) und anschließend jährlich anhand der RTOG-und LENT-SOMA-Skalen erhoben. Ergebnisse: 23 von 31 Patienten (74%) erfuhren eine Abnahme des CTC-Grades innerhalb von 8 Tagen im Median. Dadurch war der Unterschied in der Häufigkeit und Schwere der Proktitis vor Therapiebeginn und 14 Tage später bzw. am Ende der Radiotherapie statistisch signifikant. Der mediane Follow-up lag bei 50 Monaten. 20 Patienten entwickelten keine späte Proktitis. 11 Patienten entwickelten eine Grad-I-und 2 von diesen Patienten ebenfalls eine Grad-II-Toxizität. Es konnte keine signifikante Korrelation zwischen der Effektivität der Natriumbutyrat-Einläufe und Prävention bzw. Entwicklung einer späten Toxizität entdeckt werden. Schlussfolgerung: Natriumbutyrat-Einläufe sind effektiv in der Behandlung der akuten radiotherapieinduzierten Proktitis bei Patienten mit Prostatakarzinom, haben aber keinen Einfluss auf die Häufigkeit und Schwere der späten Proktitis.Schlüsselwörter: Prostatakar...

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Section: Rectal Scfasupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Sodium butyrate enemas in the treatment of acute radiation-induced proctitis in patients with prostate cancer and the impact on late proctitis

Hille¹,

Herrmann²,

Kertesz³

et al. 2008

Strahlenther Onkol

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show abstract

“…53 Several studies of SCFA enemas to promote healing of postradiation mucosal lesions have yielded conflicting results. Initial studies indicated a decrease in rectal bleeding and endoscopic improvements with SCFA use, [54][55][56] but those findings were not reproduced in a subsequent prospective, randomized, double-blind study.…”

Section: Short-chain Fatty Acid Enemasmentioning

confidence: 97%

Late rectal complications after prostate brachytherapy for localized prostate cancer

Phan¹,

Swanson²,

Levy³

et al. 2009

Cancer

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This review of the literature on late rectal complications after prostate brachytherapy indicated that it is a highly effective treatment modality for patients with clinically localized prostate cancer but can cause chronic radiation proctitis. The most common manifestation of chronic radiation proctitis was anterior rectal wall bleeding, which often occurred within the first 2 years after brachytherapy. It is interesting to note that the rates of late rectal morbidity appear to have declined over time, which may reflect improvements in implantation techniques and imaging. Rectal biopsy as part of the workup to evaluate rectal bleeding can lead to rectal fistula and the need for colostomy, a rare but major complication. The authors recommend 1) screening colonoscopy before brachytherapy for patients who have not had a screening colonoscopy within the preceding 3 years to rule out colorectal malignancies and, thus, facilitate conservative management should rectal bleeding occur; 2) lifestyle modifications during treatment to limit exposure of the rectum to radiation; and 3) conservative management for rectal bleeding that occurs within 2 years after brachytherapy. Prostate cancer is the leading cause of cancer in men and accounts for approximately 33% of cancer deaths among men in the US.1,2 Management options for organ-confined, low-to intermediate-risk prostate cancer include watchful waiting, radical prostatectomy, external-beam radiation therapy, and prostate brachytherapy with permanent interstitial implants. Recent improvements in radioactive seed implantation techniques have established prostate brachytherapy as a highly effective treatment modality for localized prostate cancer, with long-term local and biochemical control similar to outcomes observed after radical prostatectomy and external-beam radiation therapy. 3,4 Because prostate cancer is diagnosed

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“…Between the endoscopic therapies available, argon plasma coagulation is effective in reducing short-term symptoms (<6 weeks) of chronic radiation proctitis [21,22] as suggested in several case series [23][24][25]. Other effective therapies described are the argon and Nd: YAG laser, cryoablation, bipolar electrocoagulation (BiCap), heater probe, hyperbaric oxygen therapy (HBO), hormonal therapy, antioxidants and metronidazole [26,27].…”

Section: Journal Of Adenocarcinoma Issn 2572-309xmentioning

confidence: 99%

Comparison of Endoscopic Therapies for Chronic Radiation Proctitis: A Systematic Review and Meta-Analysis

Bustamante¹,

Moura²,

Bernardo³

et al. 2016

J Adenocarcinoma

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Topical butyrate for acute radiation proctitis: randomised, crossover trial

Cited by 121 publications

References 12 publications

Sodium butyrate enemas in the treatment of acute radiation-induced proctitis in patients with prostate cancer and the impact on late proctitis

Sodium butyrate enemas in the treatment of acute radiation-induced proctitis in patients with prostate cancer and the impact on late proctitis

Late rectal complications after prostate brachytherapy for localized prostate cancer

Comparison of Endoscopic Therapies for Chronic Radiation Proctitis: A Systematic Review and Meta-Analysis

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