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1.
Cancer Med ; 9(3): 912-919, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31828956

RESUMO

OBJECTIVE: The aim of this study was to evaluate the effect of the interval between CRT and surgery on radiation proctitis, the pathologic response, and postoperative morbidity. METHODS: This was a cohort study from a phase III, randomized controlled trial (FOWARC study, NCT01211210). Data were retrieved from the leading center of the trial. Patients were divided into the short-interval (≤7 weeks) group and the long-interval (>7 weeks) group. The rate of radiation proctitis, pathologic complete regression (pCR) and morbidities were calculated for each group. Multivariate analysis was used to verify the impact of interval on radiation proctitis. RESULTS: Surgery was performed in 60 patients after an interval of ≤7 weeks and in 97 patients after an interval of >7 weeks. The two groups according to interval were comparable in terms of baseline demographic and clinicotherapeutic characteristics. Radiation proctitis was identified by imaging in 9 (15.0%) patients in short-interval group and in 31 (32.0%) patients in long-interval group (P = .018). Multivariate analysis confirmed the correlation between long interval and radiation proctitis (P = .018). The long interval was significantly associated with longer median operation time compared to the short interval (P = .022). The rates of pCR and postoperative complications were not different between two groups. CONCLUSIONS: A longer interval after CRT may be associated with higher rate of radiation proctitis and longer operation time. Moreover it did not increase the rate of pCR.


Assuntos
Terapia Neoadjuvante/efeitos adversos , Protectomia/estatística & dados numéricos , Proctite/epidemiologia , Lesões por Radiação/epidemiologia , Neoplasias Retais/terapia , Tempo para o Tratamento/estatística & dados numéricos , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia Adjuvante/efeitos adversos , Quimiorradioterapia Adjuvante/métodos , Estudos de Coortes , Fracionamento da Dose de Radiação , Feminino , Fluoruracila/uso terapêutico , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/efeitos da radiação , Mucosa Intestinal/cirurgia , Leucovorina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Compostos Organoplatínicos/uso terapêutico , Proctite/diagnóstico , Proctite/etiologia , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Neoplasias Retais/mortalidade , Reto/diagnóstico por imagem , Reto/efeitos da radiação , Reto/cirurgia , Fatores de Tempo , Resultado do Tratamento
2.
Asian Pac J Cancer Prev ; 17(2): 631-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26925655

RESUMO

Radiation proctitis is a common complication after radiotherapy for pelvic malignant tumors. This study was conducted to assess the efficacy of novel almagate enemas in hemorrhagic chronic radiation proctitis (CRP) and evaluate risk factors related to rectal deep ulcer or fistula secondary to CRP. All patients underwent a colonoscopy to confirm the diagnosis of CRP and symptoms were graded. Typical endoscopic and pathological images, risk factors, and quality of life were also recorded. A total of 59 patients were enrolled. Gynecological cancers composed 93.1% of the primary malignancies. Complete or obvious reduction of bleeding was observed in 90% (53/59) patients after almagate enema. The mean score of bleeding improved from 2.17 to 0.83 (P<0.001) after the enemas. The mean response time was 12 days. No adverse effects were found. Moreover, long-term successful rate in controlling bleeding was 69% and the quality of life was dramatically improved (P=0.001). The efficacy was equivalent to rectal sucralfate, but the almagate with its antacid properties acted more rapidly than sucralfate. Furthermore, we firstly found that moderate to severe anemia was the risk factor of CRP patients who developed rectal deep ulcer or fistulas (P= 0.015). We also found abnormal hyaline-like thick wall vessels, which revealed endarteritis obliterans and the fibrosis underlying this disease. These findings indicate that almagate enema is a novel effective, rapid and well-tolerated method for hemorrhagic CRP. Moderate to severe anemia is a risk factor for deep ulceration or fistula.


Assuntos
Hidróxido de Alumínio/uso terapêutico , Carbonatos/uso terapêutico , Enema/métodos , Fístula/etiologia , Hemorragia Gastrointestinal/terapia , Hidróxido de Magnésio/uso terapêutico , Neoplasias/complicações , Proctite/terapia , Lesões por Radiação/terapia , Radioterapia/efeitos adversos , Adulto , Idoso , Antiácidos/uso terapêutico , Colonoscopia , Feminino , Fístula/diagnóstico , Seguimentos , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/patologia , Neoplasias/radioterapia , Proctite/diagnóstico , Proctite/etiologia , Prognóstico , Qualidade de Vida , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Estudos Retrospectivos , Fatores de Risco
3.
Zhonghua Wei Chang Wai Ke Za Zhi ; 14(3): 188-91, 2011 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-21442481

RESUMO

OBJECTIVE: To investigate risk factors associated with prognosis in patients with radiation proctitis (RP). METHODS: Between August 2007 and February 2010, 33 patients diagnosed with radiation proctitis were identified. Data pertaining to treatments and quality of life(QOL) were analyzed retrospectively. RESULTS: Indication for radiation included cervical cancer(n=22), prostate cancer (n=3), ovary cancer (n=2), rectal cancer (n=2), endometrial cancer(n=2), cervical cancer (n=1), and vaginal cancer(n =1). Data regarding radiation were available in 18 patients, and the mean dose was (61.3±12.9) Gy with a median dose of 61 Gy. Eleven were treated with enema therapy, 9 formalin dab, 12 surgical operations. Clinical improvement was noticed in 75% of the patients with a mean QOL score of 63.79±20.92. Prognosis was favorable in 75% of the patients. Surgical treatment was effective in 91.7% of the patients with severe complications. Univariate analysis showed that gender was associated with the prognosis of RP, while the severity of RP and treatment method were not predictive for RP prognosis. CONCLUSIONS: Gender but not disease severity is associated with the prognosis of radiation proctitis. Surgery may be beneficial to RP patients with severe complications.


Assuntos
Proctite/diagnóstico , Lesões por Radiação/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Proctite/etiologia , Proctite/terapia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
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