Research Report
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World J Gastroenterol. Apr 21, 2014; 20(15): 4341-4344
Published online Apr 21, 2014. doi: 10.3748/wjg.v20.i15.4341
Role of triamcinolone in radiation enteritis management
Eren Cetin, Aysen Sevgi Ozturk, Haluk Orhun, Sukran Ulger
Eren Cetin, Sukran Ulger, Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara 06500, Turkey
Aysen Sevgi Ozturk, Haluk Orhun, Division of Radiation Oncology, Medicana International Hospital, Ankara 06500, Turkey
Author contributions: Cetin E and Ozturk AS contributed equally to this work; Cetin E designed the research; Cetin E, Ozturk AS and Orhun H performed the research; Cetin E analyzed data; Cetin E and Ulger S wrote the paper.
Correspondence to: Dr. Eren Cetin, Department of Radiation Oncology, Faculty of Medicine, Gazi University, Besevler, Ankara 06500, Turkey. erencetin@gazi.edu.tr
Telephone: +90-312-2026595
Received: July 23, 2013
Revised: November 25, 2013
Accepted: January 2, 2014
Published online: April 21, 2014
Abstract

AIM: To investigate the role of triamcinolone in the management of acute and chronic enteritis caused by pelvic radiotherapy.

METHODS: Twenty-eight patients with rectum adenocarcinoma or endometrium adenocarcinoma were studied. We compared the results of 14 patients treated with injected triamcinolone acetonide (TA) with those of 14 patients who were not treated with TA. For the TA group, 40 mg of TA was injected intramuscularly on the 1st, 11th and 21st d of radiotherapy; the control group received no injections. All of the study participants had a median age of 65 years, had undergone postoperative radiotherapy and were evaluated weekly using Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer Acute Morbidity Score Criteria, and complete blood counts for every 10 d.

RESULTS: Triamcinolone was found to effectively prevent and treat radiation-induced acute gastrointestinal (enteritis) and genitourinary (cystitis) side effects (P = 0.022 and P = 0.023). For the lower GI side effect follow up, 11 patients in the control group had Grade 2 toxicity and 3 patients had Grade 1 toxicity. In the TA group, 5 patients had Grade 2 toxicity and 9 patients had Grade 1 toxicity. For the genitourinary system side effect follow up, 4 patients had Grade 2 toxicity and 6 patients had Grade 1 toxicity. Additionally, 2 patients had Grade 2 toxicity and 2 patients had Grade 1 toxicity. The neutrophil counts did not differ between the TA group and the control group. There was no meaningful difference between age groups and primary cancers. At the 12th mo of follow up, there were no differences between groups for chronic side effects.

CONCLUSION: Triamcinolone is a moderately potent steroid, that is inexpensive and has a good safety profile. It would be beneficial for reducing medical expenses related to treatment of radiation induced enteritis.

Keywords: Radiotherapy, Enteritis, Cystitis, Triamcinolone

Core tip: Radiation enteritis, proctitis and cystitis are acute side effects of radiotherapy of the pelvic region that change patients’ performance status and can interrupt the radiotherapy program. An important effort should be made to treat the side effects and to provide patient follow-up. Many drugs are available to treat the side effects, and although supportive digestive supplements may be used, the medical expenses associated with tratment are increasing, and the patients are suffering. In this study, we evaluated the role of triamcinolone acetonide, which is moderately effective, low-priced and easy to use, in the management of acute gastrointestinal and genitourinary system side effects.