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Sucralfate does not ameliorate acute radiation proctitis: randomised study and meta-analysis.
1Division of Gastroenterology, Section of Oncology, Haukeland University Hospital, University of Bergen, Bergen, Norway. nils.hovdenak@helse-bergen.no
Clinical Oncology (Royal College of Radiologists (Great Britain))
|September 10, 2005
Summary
Prophylactic sucralfate did not prevent radiation proctopathy during pelvic radiotherapy and may worsen diarrhea. A meta-analysis confirmed no significant benefit for acute symptoms.
Area of Science:
- Oncology
- Gastroenterology
- Radiotherapy
Background:
- Pelvic radiotherapy frequently causes gastrointestinal symptoms, impacting treatment adherence.
- Prophylaxis aims to prevent acute reactions and delayed radiation injury.
- Sucralfate has been investigated for radiation side-effects, but results are conflicting.
Purpose of the Study:
- To evaluate the efficacy of prophylactic sucralfate in preventing acute radiation proctopathy.
- To conduct a meta-analysis of existing studies on sucralfate for radiation-induced gastrointestinal symptoms.
Main Methods:
- A prospective, randomized, placebo-controlled trial involving 51 patients undergoing pelvic radiotherapy.
- Patients received either sucralfate or placebo during radiotherapy.
- Symptom assessment, endoscopy, and biopsies were performed at multiple time points.
Main Results:
- An interim analysis of 44 patients showed significantly increased diarrhea in the sucralfate group, leading to trial cessation.
- No differences were observed in other symptoms, endoscopic findings, or histology.
- A meta-analysis of five studies found no statistically significant benefit of sucralfate for acute symptoms.
Conclusions:
- Sucralfate is not recommended for preventing acute radiation proctopathy.
- Sucralfate may potentially exacerbate radiation-induced gastrointestinal symptoms.