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[Acute gastrointestinal side effects of radiotherapy. What is certain in the treatment?]
F Paulsen1, W Hoffmann, R D Kortmann
1Abteilung für Strahlentherapie, Radiologische Universitätsklinik, Tübingen.
Purpose:
Radiotherapy, especially in the abdominal region, is frequently associated with gastrointestinal side effects.
Methods:
The article reviews the current knowledge about pathophysiological background, clinical symptoms and the treatment strategies of the major gastrointestinal side effects.
Results:
Several basics are investigated and depending on this knowledge some special treatment strategies have been developed (5-HT3-receptor-antagonists in the treatment of nausea, Figure 1, Table 2). The treatment of stomatitis, esophagitis, enteritis and proctitis still remains symptomatic and is not yet standardized (Tables 3 to 6). There are some promising results with smectit (enteritis) and sucralfat. Special dental attendance should be performed before initiating radiotherapy of the head and neck region. Technical improvement in radiotherapy will also help to reduce side effects.
Conclusion:
In order to minimize gastrointestinal side effects, it is necessary to further investigate the pathophysiology of acute and late toxicity.