Copyright
©The Author(s) 2021.
World J Gastrointest Oncol. May 15, 2021; 13(5): 400-408
Published online May 15, 2021. doi: 10.4251/wjgo.v13.i5.400
Published online May 15, 2021. doi: 10.4251/wjgo.v13.i5.400
Table 1 Treatment modalities for radiation proctopathy and associated bleeding
Treatment modality | Benefit | Drawback |
Sucralfate enema | (1) Inexpensive; (2) Safe[41]; and (3) Effective first line in > 70%[46] | Patient training to self-administer or access to qualified clinician in nonclinical setting |
Formalin enema | Efficacy in at least 75% cases[47] | (1) Requires qualified therapist; and (2) Variable morbidity, serious side effects such as fistulization and severe colitis[42] |
Hyperbaric oxygen | Improved bowel related symptoms following radiation treatment | (1) Not readily available; (2) Requires recurrent treatments to provide efficacy[30]; and (3) No strong RCT evidence for benefit |
APC | (1) Direct visualization allows for treatment of a distinct bleeding point; and (2) Readily available within secondary care | (1) Procedural complications, e.g., perforation, bleeding; (2) Strictures; and (3) Ulceration |
Table 2 Overview of specific therapies for side effects associated with radiation therapy
Area | Side effect | Treatment |
Oral mucosa | Mucositis; xerostomia; candidiasis | Opioids, topical benzydamine; artificial saliva; topical antifungals |
Esophagus | Esophagitis; strictures | Analgesia, topical anesthesia, PPI; esophageal dilatation, CARD, esophageal stents |
Small bowel | Enteritis; small bowel overgrowth; strictures; bile acid malabsorption; malnutrition | Antidiarrheal; antibiotics; surgery; bile acid sequestrants; nutritional adjuncts (i.e. PN) |
Rectum | Proctopathy | Sucralfate, formalin, HBOT, APC |
- Citation: McCaughan H, Boyle S, McGoran JJ. Update on the management of the gastrointestinal effects of radiation. World J Gastrointest Oncol 2021; 13(5): 400-408
- URL: https://www.wjgnet.com/1948-5204/full/v13/i5/400.htm
- DOI: https://dx.doi.org/10.4251/wjgo.v13.i5.400