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Medical prevention and treatment of acute and chronic radiation induced enteritis--is there any proven therapy? a short review.
Z Gastroenterol 2008; 46(5):441-8ZG

Abstract

BACKGROUND

Radiation enteritis is a severe problem in patients receiving irradiation of the abdomen or pelvis in the course of cancer treatment. Nevertheless, there is a lack of standardised strategies for medical prevention and therapy.

MATERIALS AND METHODS

A PubMed based literature search was performed to address the available data on the prevention of and therapy for acute and chronic radiation enteritis.

RESULTS

Four double-blind and placebo-controlled studies used 5-aminosalycilates in the prevention of acute radiation enteritis. Only for sulphasalzine 2 g/d was a positive effect proven. Prophylactic administration of probiotics reduced the incidence of acute radiation enteritis in a large placebo-controlled trial. If acute radiation enteritis was present octreotide ameliorated radiation-induced diarrhoea in a randomised study. Two investigations, only one of them randomised, described the effectiveness of loperamide in the treatment of acute radiation enteritis. If diarrhoea was also the main symptom of chronic radiation enteritis, loperamide reduced stool frequency in a double-blind and placebo-controlled study. A retrospective analysis of severe cases of chronic radiation enteritis with obstruction and fistula indicated that parenteral nutrition at home was more effective than surgery.

CONCLUSION

Reduction of radiation dose and field size are still the most important factors in the prevention of acute and chronic radiation enteritis. Valid data particularly on the treatment of chronic radiation enteritis are lacking. A better understanding of the pathopysiology especially in chronic radiation enteritis might offer new therapeutic perspectives. Inhibition of TGF-beta, for example, might be a new promising therapy approach.

Authors+Show Affiliations

Department of Medicine II, University Hospital Mannheim.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18461520

Citation

Zimmerer, T, et al. "Medical Prevention and Treatment of Acute and Chronic Radiation Induced Enteritis--is There Any Proven Therapy? a Short Review." Zeitschrift Fur Gastroenterologie, vol. 46, no. 5, 2008, pp. 441-8.
Zimmerer T, Böcker U, Wenz F, et al. Medical prevention and treatment of acute and chronic radiation induced enteritis--is there any proven therapy? a short review. Z Gastroenterol. 2008;46(5):441-8.
Zimmerer, T., Böcker, U., Wenz, F., & Singer, M. V. (2008). Medical prevention and treatment of acute and chronic radiation induced enteritis--is there any proven therapy? a short review. Zeitschrift Fur Gastroenterologie, 46(5), pp. 441-8. doi:10.1055/s-2008-1027150.
Zimmerer T, et al. Medical Prevention and Treatment of Acute and Chronic Radiation Induced Enteritis--is There Any Proven Therapy? a Short Review. Z Gastroenterol. 2008;46(5):441-8. PubMed PMID: 18461520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medical prevention and treatment of acute and chronic radiation induced enteritis--is there any proven therapy? a short review. AU - Zimmerer,T, AU - Böcker,U, AU - Wenz,F, AU - Singer,M V, PY - 2008/5/8/pubmed PY - 2008/8/19/medline PY - 2008/5/8/entrez SP - 441 EP - 8 JF - Zeitschrift fur Gastroenterologie JO - Z Gastroenterol VL - 46 IS - 5 N2 - BACKGROUND: Radiation enteritis is a severe problem in patients receiving irradiation of the abdomen or pelvis in the course of cancer treatment. Nevertheless, there is a lack of standardised strategies for medical prevention and therapy. MATERIALS AND METHODS: A PubMed based literature search was performed to address the available data on the prevention of and therapy for acute and chronic radiation enteritis. RESULTS: Four double-blind and placebo-controlled studies used 5-aminosalycilates in the prevention of acute radiation enteritis. Only for sulphasalzine 2 g/d was a positive effect proven. Prophylactic administration of probiotics reduced the incidence of acute radiation enteritis in a large placebo-controlled trial. If acute radiation enteritis was present octreotide ameliorated radiation-induced diarrhoea in a randomised study. Two investigations, only one of them randomised, described the effectiveness of loperamide in the treatment of acute radiation enteritis. If diarrhoea was also the main symptom of chronic radiation enteritis, loperamide reduced stool frequency in a double-blind and placebo-controlled study. A retrospective analysis of severe cases of chronic radiation enteritis with obstruction and fistula indicated that parenteral nutrition at home was more effective than surgery. CONCLUSION: Reduction of radiation dose and field size are still the most important factors in the prevention of acute and chronic radiation enteritis. Valid data particularly on the treatment of chronic radiation enteritis are lacking. A better understanding of the pathopysiology especially in chronic radiation enteritis might offer new therapeutic perspectives. Inhibition of TGF-beta, for example, might be a new promising therapy approach. SN - 0044-2771 UR - https://www.unboundmedicine.com/medline/citation/18461520/Medical_prevention_and_treatment_of_acute_and_chronic_radiation_induced_enteritis__is_there_any_proven_therapy_a_short_review_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2008-1027150 DB - PRIME DP - Unbound Medicine ER -