CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(01): 085-098
DOI: 10.1055/s-0041-1742258
Review Article

Therapeutics in Radiation-induced Proctopathy: A Systematic Review

1   Postgraduate Department in Sciences Applied to Surgery and Ophthalmology, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil
,
Ivana Duval de Araujo
2   Doctor and Associate Professor IV, Department of Surgery, Universidade Federal de Minas Gerais, Brazil
,
Geraldo Magela Gomes da Cruz
3   Coloproctologist in charge, Sociedade Brasileira de Coloproctologia, Brazil
,
Fábio Gontijo Rodrigues
3   Coloproctologist in charge, Sociedade Brasileira de Coloproctologia, Brazil
› Author Affiliations

Abstract

Malignant neoplasms are increasingly prevalent in the daily clinical practice. Up to 61% of patients with pelvic malignancies undergo pelvic radiotherapy in different doses, which may cause intestinal damage, and the rectum is the segment most frequently affected due to its fixed position in the pelvis. Currently, there are several strategies to minimize the effects of radiation on the tissues surrounding the neoplastic site; despite those strategies, radiotherapy can still result in serious damage to organs and structures, and these injuries accompany patients throughout their lives. One of the most common damages resulting from pelvic radiotherapy is acute proctitis.The diagnosis is confirmed by visualizing the rectal mucosa through rigid or flexible rectosigmoidoscopy and colonoscopy. The objective of the present study was to review the forms of radiation-induced proctopathytherapy, and to evaluate the results of each method to propose a standardization for the treatment of this pathology. Despite the prevalence of radiation-induced proctopathy, there is no definitive standardized treatment strategy so far. The first approach can be tried with local agents, such as mesalazine and formalin. For refractory cases, control can usually be achieved with argon plasma coagulation, hyperbaric oxygen, and radiofrequency ablation therapies. Regarding the study of radiation-induced proctopathy, there is a lack of robust studies with large samples and standardized therapies to be compared. There is a lack of double-blinded, randomized controlled studies to determine a definitive standard treatment algorithm.



Publication History

Received: 03 August 2021

Accepted: 25 October 2021

Article published online:
07 March 2022

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