Rapid Communication
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2007; 13(26): 3610-3613
Published online Jul 14, 2007. doi: 10.3748/wjg.v13.i26.3610
Long-term prognosis in patients with severe late radiation enteropathy: A prospective cohort study
Annette Larsen, Jon B Reitan, Steinar T Aase, Martin Hauer-Jensen
Annette Larsen, Institute of Internal Medicine, Department of Oncology, Haukeland University Hospital, N-5021 Bergen, Norway
Jon B Reitan, Department of Oncology, The Norwegian Radium Hospital, N-0310 Oslo, Norway
Steinar T Aase, Department of Pathology, Haukeland University Hospital, N-5021 Bergen, Norway
Martin Hauer-Jensen, Departments of Surgery and Pathology, University of Arkansas for Medical Sciences, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Annette Larsen, Department of Oncology, Haukeland University Hospital, N-5021 Bergen, Norway. annette.larsen@helse-bergen.no
Telephone: +47-55-972010 Fax: +47-55-972046
Received: March 31, 2007
Revised: April 2, 2007
Accepted: April 18, 2007
Published online: July 14, 2007
Abstract

AIM: To assess persistent symptoms and mortality in a cohort of patients with severe (grade 3-4) radiation enteropathy, 59 patients were followed up after 15-18 years.

METHODS: Fifty-nine patients were prospectively enrolled by twelve surgical departments. Primary malignant disease, radiation therapy and surgical management were recorded at inclusion. The cause of death or persistence of symptoms was examined in public death records or by interview of survivors.

RESULTS: Thirty-nine patients had received radiation therapy for gynaecological cancers, twelve for urological cancers, four for gastrointestinal cancers and four for other malignancies. Forty-five patients (76%) required surgical intervention. Complications occurred in 11 (25%) operated patients. Forty-seven patients had died at the time of follow-up, seven (12%) died as a direct result of radiation enteropathy, while radiation enteropathy contributed to death in an additional seven patients. Four of the twelve surviving patients suffered from chronic debilitating symptoms of radiation enteropathy, while three had moderate symptoms.

CONCLUSION: Patients with severe delayed radiation enteropathy have a high risk of persistence of symptoms after surgery. At least one in ten patients dies from radiation-induced bowel injury.

Keywords: Radiation enteropathy; Long-term follow up