Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2023; 11(5): 1129-1136
Published online Feb 16, 2023. doi: 10.12998/wjcc.v11.i5.1129
Administration of modified Gegen Qinlian decoction for hemorrhagic chronic radiation proctitis: A case report and review of literature
Shao-Yong Liu, Liu-Ling Hu, Shi-Jun Wang, Zhong-Li Liao
Shao-Yong Liu, Traditional Chinese Medicine Cancer Treatment Center, Chongqing University Cancer Hospital, Chongqing 400030, China
Liu-Ling Hu, Shi-Jun Wang, Zhong-Li Liao, The Center for Gastroenterology, Diagnosis and Minimally Invasive Treatment of Early Gastrointestinal Cancer, Chongqing University Cancer Hospital, Chongqing 400030, China
Author contributions: Liu SY, Hu LL, Wang SJ, Liao ZL performed the research; Liu SY wrote the manuscript; Liao ZL wrote and designed the research; All authors have read and approve the final manuscript.
Supported by The Chongqing Research Program of Basic Research and Frontier Technology, No. cstc2018jcyjAX0775; and The Open Foundation of The Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Li Liao, MD, Associate Chief Physician, The Center for Gastroenterology, Diagnosis and Minimally Invasive Treatment of Early Gastrointestinal Cancer, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Chongqing 400030, China. liaozlxhk@163.com
Received: October 25, 2022
Peer-review started: October 25, 2022
First decision: December 13, 2022
Revised: December 24, 2022
Accepted: January 20, 2023
Article in press: January 20, 2023
Published online: February 16, 2023
Abstract
BACKGROUND

Hemorrhagic chronic radiation proctitis (CRP) is a common late complication of irradiation of the pelvis and seriously impairs life quality. There is no standard treatment for hemorrhagic CRP. Medical treatment, interventional treatment, and surgery are available, but they are limited in their applications due to nondefinite efficacy or side effects. Chinese herbal medicine (CHM), as a complementary or alternative therapy, may provide another option for hemorrhagic CRP treatment.

CASE SUMMARY

A 51-year-old woman with cervical cancer received intensity-modulated radiation therapy and brachytherapy with a total dose of 93 Gy fifteen days after hysterectomy and bilateral adnexectomy. She received six additional cycles of chemotherapy with carboplatin and paclitaxel. Nine months after radiotherapy treatment, she mainly complained of 5-6 times diarrhea daily and bloody purulent stools for over 10 d. After colonoscopy examinations, she was diagnosed with hemorrhagic CRP with a giant ulcer. After assessment, she received CHM treatment. The specific regimen was 150 mL of modified Gegen Qinlian decoction (GQD) used as a retention enema for 1 mo, followed by replacement with oral administration of 150 mL of modified GQD three times per day for 5 mo. After the whole treatment, her diarrhea reduced to 1-2 times a day. Her rectal tenesmus and mild pain in lower abdomen disappeared. Both colonoscopy and magnetic resonance imaging confirmed its significant improvement. During treatment, there were no side effects, such as liver and renal function damage.

CONCLUSION

Modified GQD may be another effective and safe option for hemorrhagic CRP patients with giant ulcers.

Keywords: Hemorrhagic chronic radiation proctitis, Chinese herbal medicine, Gegen Qinlian decoction, Retention enema, Case report

Core Tip: We report a case of hemorrhagic chronic radiation proctitis (CRP) in a patient with a giant rectal ulcer who achieved significant remission via retention enema and oral administration of modified Gegen Qinlian decoction (GQD). As an alternative and complementary medicine, modified GQD may be another effective and safe option for hemorrhagic CRP patients with giant ulcers in the absence of standard treatments.