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Radiation proctitis: a decade's experience
1Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Medical Journal
|May 28, 2010
Summary
Radiation proctitis, a common side effect of pelvic radiotherapy, often presents with rectal bleeding. While topical treatments are effective for most, severe cases may require surgery.
Area of Science:
- Oncology
- Gastroenterology
- Radiation Oncology
Background:
- Pelvic radiotherapy is crucial for treating pelvic malignancies but can cause rectal injury.
- Radiation proctitis is a significant collateral damage of pelvic radiation therapy.
Purpose of the Study:
- To analyze the clinical characteristics and treatment outcomes of patients with radiation proctitis.
- To evaluate the efficacy of different treatment modalities for radiation proctitis.
Main Methods:
- Retrospective analysis of prospectively gathered patient data over a 10-year period (1995-2004).
- Inclusion of patient demographics, cancer type, radiotherapy details, symptoms, diagnosis, treatments, and follow-up duration.
- Analysis of presenting symptoms, latent period, and treatment responses.
Main Results:
- 77 patients treated for radiation proctitis; median follow-up of 14 months.
- Most common cancers: gynecological (63.6%), prostate (18.2%), colorectal (15.6%).
- Rectal bleeding (89.6%) was the primary symptom, with a median latent period of 24 months. Topical formalin was used in 72.5% of cases, often requiring repeat treatments. Surgery was necessary for 18.2% due to intractable bleeding or complications.
Conclusions:
- Radiation proctitis presents a therapeutic challenge, requiring tailored management.
- Topical treatments are effective for most cases of rectal bleeding.
- Surgery remains essential for managing severe or life-threatening symptoms of radiation proctitis.
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