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Interventions for Managing Late Gastrointestinal Symptoms Following Pelvic Radiotherapy: a Systematic Review and
H Berntsson1, A Thien2, D Hind1
1Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|March 2, 2024
Summary
Pelvic radiotherapy can cause gastrointestinal issues. 4% formalin and counselling show promise for symptom management, but more research is needed for definitive conclusions on various interventions.
Area of Science:
- Oncology
- Gastroenterology
- Clinical Research
Background:
- Pelvic radiotherapy frequently leads to gastrointestinal (GI) injuries and symptoms.
- These adverse effects significantly impact patients' quality of life.
- Effective management strategies for radiation-induced GI symptoms are crucial.
Approach:
- A comprehensive systematic review and meta-analysis was performed.
- Included randomized controlled trials (RCTs) published between January 1990 and June 2023.
- Searched major databases and grey literature for relevant studies.
Key Points:
- Twenty-eight studies with 2392 participants were analyzed.
- 4% formalin demonstrated superiority over sucralfate in improving GI symptom scores (SMD -1.07).
- Counselling also positively influenced symptom scores (SMD -0.53), while argon plasma coagulation (APC) showed mixed results.
- Sucralfate combined with APC increased bleeding risk compared to APC alone.
Conclusions:
- Methodological quality and heterogeneity across studies limit definitive conclusions for individual interventions.
- Argon plasma coagulation (APC) and 4% formalin emerge as potentially promising interventions.
- Larger, high-quality randomized controlled trials are warranted to confirm efficacy and guide clinical practice.
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