Long-term prognosis of patients with severe radiation enteritis

One hundred thirty-six patients (median age 59 years) presented with intestinal complications of previous radiotherapy. Seventy-eight had bleeding or stricture and 58 had perforation or fistula. One hundred twenty-four patients survived for more than 3 months and were followed for a median of 4.5 years. Sixty-eight patients were free of symptoms, whereas 16 experienced operation-related complications. Twelve patients had continuing symptoms of radiation enteritis, and new radiation-induced complications developed in 28. Sixteen of 51 patients with perforation or fistula had new complications compared with 12 of 73 patients with bleeding of stricture (p = 0.05). Overall, 57 patients died during the study. Thirteen died from radiation-induced complications and 27, from recurrent malignancy. Radiation deaths occurred in the postoperative period but had no impact on long-term survival. Life expectancy was poorer in patients presenting with perforation or fistula compared with bleeding or stricture, the main reason being significantly more recurrences among patients with fistulas (p less than 0.05).