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radiation proctitis

Fadi H Mourad, Rupert W Leong
Despite the recent advances in endoscopic hemostatic techniques, the management of lower gastrointestinal bleeding could be sometimes challenging. Hemostatic powders such as hemospray, endoclot and Ankafred Blood Stopper have found their way into digestive endoscopy and are licenced in many countries especially for use in upper gastrointestinal bleeding. We reviewed the literature on the use of these hemostatic powders in different situations in lower gastrointestinal bleeding and looked at the success rate and rebleeding rate...
February 6, 2018: Journal of Gastroenterology and Hepatology
Masaharu Hata, Izumi Koike, Etsuko Miyagi, Reiko Numazaki, Mikiko Asai-Sato, Hisashi Kaizu, Yuki Mukai, Shoko Takano, Eiko Ito, Madoka Sugiura, Tomio Inoue
Purpose: To evaluate the safety and efficacy of radiation therapy for stage IVA uterine cervical cancer and to identify an optimal radiation regimen. Results: Seventeen of the 28 patients developed recurrence after radiation therapy (local recurrence in 10 and distant metastasis in 12). The local control and distant metastasis-free rates at 3 years in all patients were 61% and 49%, respectively. Fourteen patients died after radiation therapy, and all but 2 died of tumor progression...
December 22, 2017: Oncotarget
Jorgo Kliton, Csaba Polgár, Péter Tenke, Gábor Kovács, Tibor Major, Gábor Stelczer, Péter Ágoston
INTRODUCTION AND AIM: To implement lipiodol as a fiducial marker of the tumor bed for image-guided radiotherapy with simultaneous integrated boost technique as part of radiochemotherapy for muscle invasive bladder tumors. METHOD: Since April 2016, radiochemotherapy was performed in 3 male patients with muscle invasive, transitional cell bladder carcinoma. Prior to radiochemotherapy, tumor bed resection was performed for each patient, at the same time 10 ml of lipiodol solution was injected submucosally into the resection site, thus marking the tumor bed for escalated dose irradiation...
December 2017: Orvosi Hetilap
Georgia K B Halkett, Michala Short, Samar Aoun, David Joseph, Sean Bydder, Xingqiong Meng, Nigel Spry
Purpose: Research describing proctitis or pelvic radiation disease symptoms of prostate cancer patients one year after external beam radiotherapy (EBRT) plus high-dose-rate (HDR) brachytherapy is limited. This study aimed to assess prostate cancer patients' pelvic radiation disease symptoms from baseline to 12 months post-radiotherapy. Material and methods: Men with prostate cancer referred for EBRT and HDR brachytherapy were recruited. Patients' age, diagnosis, staging, PSA, past medical history, and treatment were recorded...
October 2017: Journal of Contemporary Brachytherapy
Ivy Wei Shan Ng, Jeremy Chee Seong Tey, Yu Yang Soon, Michelle Shu Fen Tseng, Desiree Chen, Keith Hsiu Chin Lim
AIM: External beam radiotherapy (EBRT) followed by high dose rate (HDR) brachytherapy boost has demonstrated minimal toxicities and improved disease control rate compared with EBRT alone in observational and randomized studies with predominantly Caucasian patients. This study aims to report the outcomes of patients treated with this approach in our predominantly Asian population. METHODS: Medical records for patients with localized prostate cancer who received combined EBRT delivered via intensity modulated radiotherapy (IMRT) technique followed by HDR brachytherapy boost were retrospectively reviewed...
November 23, 2017: Asia-Pacific Journal of Clinical Oncology
Jeremy Tey, Cheng Nang Leong, Wai Kit Cheong, Tay Guan Sze, Wei Peng Yong, Ivan Weng Keong Tham, Khai Mun Lee
Objectives: To determine the pathological response rates and toxicity and in patients with locally advanced rectal cancer treated with concurrent capecitabine and dose escalated intensity modulated radiotherapy (IMRT) Methods: Patients with stage II or III adenocarcinoma of the rectum were treated with preoperative concurrent capecitabine and IMRT. Dose of capecitabine was 825mg/m2, 5 days a week for 5 weeks. IMRT was used to deliver a dose of 45Gy in 25 fractions (1.8Gy per fraction daily, 5 days a week over 5 weeks) to the regional lymphatics and areas at risk of harbouring microscopic disease...
2017: Journal of Cancer
Emilio P Araujo-Mino, Yehuda Z Patt, Cristina Murray-Krezan, Joshua A Hanson, Pranshu Bansal, Ben J Liem, Ashwani Rajput, M Houman Fekrazad, Glenory Heywood, Fa Chyi Lee
LESSONS LEARNED: Colorectal cancers exhibit a high level of cyclooxygenase-2 (COX-2) expression with strong preclinical rationale for improved clinical outcomes with COX-2 inhibition. Celecoxib is a COX-2 inhibitor and we have shown that it can be safely combined with capecitabine and oxaliplatin as part of neoadjuvant treatment with radiation therapy (RT) in rectal cancer.There was a significant improvement in skin toxicity with this combination as compared with historical data. Considering the field has moved on to single-agent capecitabine, we believe future trials with capecitabine and celecoxib hold potential...
November 20, 2017: Oncologist
F Barbera, L Triggiani, M Buglione, P Ghirardelli, P Vitali, B Caraffini, P Borghetti, D Greco, L Bardoscia, N Pasinetti, L Costa, M Maddalo, B Ghedi, B La Face, S M Magrini
Background/aim: Low dose rate brachytherapy has been used as salvage therapy for locally recurrent prostate cancer (PC) after primary external beam radiation therapy (EBRT), along with surgery and cryotherapy. All these techniques, in particular, when applied to the whole gland, involve a relatively high risk of toxicity and may worsen the patient's quality of life. Our aim is to evaluate the results of whole-gland salvage brachytherapy (SBT) after primary EBRT in terms of toxicity, functional outcomes, and efficacy...
2017: Clinical Medicine Insights. Oncology
Chuangang Fu, Zhuqing Zhou, Junyi Han, Bin Lu, Wei Gao, Zhe Zhu, Qixin Jiang, Fang Ji, Tao Du
OBJECTIVE: To introduce the use of a self-made specimen protective sleeve in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery and the improvement of implantation method, so as to avoid and reduce bacterial contamination and tumor cell dissemination in abdominal cavity. METHODS: During June 2015 and May 2017, 48 cases of high located rectal or sigmoid colon cancer were operated laparoscopically with natural orifices specimen extraction surgery (NOSES) using a self-made specimen protecting sleeve...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Madhup Rastogi, Sambit Swarup Nanda, Ajeet Kumar Gandhi, Divakar Dalela, Rohini Khurana, Surendra Prasad Mishra, Anoop Srivastava, S Farzana, Madan Lal Brahma Bhatt, Nuzhat Husain
OBJECTIVES: We compared the prostate motion variability and toxicities between patients treated with gold marker registration based IG-IMRT (IG-IMRT-M) and bony landmark registration based IG-IMRT (IG-IMRT-B). METHODS: T1c-T3b (node negative), intermediate and high risk (non-metastatic) adenocarcinoma of prostate, age ≥18years, Karnofsky Performance Status of ≥70 were included in this retrospective study. The prostate motion variability, acute and late radiation toxicities between the two treatment arms (IG-IMRT-M versus IG-IMRT-B) were compared...
November 9, 2017: Journal of the Egyptian National Cancer Institute
Thomas R McCarty, Tarun Rustagi
Radiofrequency ablation (RFA) is a well-established treatment for several benign, pre-malignant, and malignant disorders. Although the role of RFA has been clearly defined, new indications for luminal and extra-luminal applications of endoscopic RFA-directed therapies have emerged. RFA has recently produced promising results in patients with a variety of gastrointestinal and hepatopancreatobiliary pathologies. For example, endoscopic RFA has been used to treat patients with gastric antral vascular ectasia, chronic radiation proctitis, malignant biliary strictures, and ampullary adenomas with intraductal extension...
October 25, 2017: Clinical Gastroenterology and Hepatology
Peihuang Wu, Li Li, Huaiming Wang, Tenghui Ma, Haiyong Wu, Xinjuan Fan, Zihuan Yang, Daici Chen, Lei Wang
BACKGROUND: Chronic radiation proctitis (CRP), a common complication after radiotherapy for pelvic malignancies, compromises patient quality of life. Vascular damage and aberrant angiogenesis in the mucosal layer are essential histological features, but changes to the submucosal layer are unclear. Thus, we evaluated the histological characteristics and distribution changes of key angiogenic factors in full-layered human CRP samples. METHODS: Thirty paraffin-embedded CRP and twenty-nine non-CRP tissues were used to evaluate histopathological changes...
October 27, 2017: Digestive Diseases and Sciences
Radzislaw Trzcinski, Adam Dziki, Magdalena Brys, Malgorzata Moszynska-Zielinska, Justyna Chalubinska-Fendler, Michal Mik, Ryszard Kujawski, Lukasz Dziki
INTRODUCTION: The aim of this study was to assess the expression of vascular endothelial growth factor (VEGF) as a key proangiogenic factor and determine whether there is any correlation between its expression and clinical symptoms or endoscopic changes in patients with chronic radiation proctitis (ChRP). METHOD: Fifty patients who had all undergone radiotherapy for prostate, cervical and uterine cancers were included in the study (37 females, 13 males). There was a control group of 20 patients (9 females, 11 males)...
September 29, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Lino Polese, Lucia Marini, Roberto Rizzato, Edgardo Picardi, Stefano Merigliano
The purpose of this study is to determine the effectiveness of endoscopic diode laser therapy in patients presenting rectal bleeding due to chronic radiation proctitis (CRP). A retrospective analysis of CRP patients who underwent diode laser therapy in a single institution between 2010 and 2016 was carried out. The patients were treated by non-contact fibers without sedation in an outpatient setting. Fourteen patients (median age 77, range 73-87 years) diagnosed with CRP who had undergone high-dose radiotherapy for prostatic cancer and who presented with rectal bleeding were included...
September 11, 2017: Lasers in Medical Science
Ashlyn Tom, Antonia V Bennett, Diana Rothenstein, Ethel Law, Karyn A Goodman
PURPOSE: Gastrointestinal (GI) symptoms pose a significant burden to patients receiving chemoradiation therapy (CRT) for anal cancer; however, the impact of symptoms from the patient perspective has not been quantified. This retrospective study examined and compared patient and clinician reports of acute GI toxicity during CRT. MATERIALS AND METHODS: Patients treated with definitive RT using intensity-modulated radiation therapy for anal cancer between 9/09 and 11/12 were reviewed...
September 7, 2017: Quality of Life Research
Fei Cao, Teng-Hui Ma, Guang-Jian Liu, Yan-Lin Wen, Huai-Ming Wang, Ying-Yi Kuang, Si Qin, Xiao-Yin Liu, Bin-Jie Huang, Lei Wang
The aim of this study was to summarize the imaging features of chronic radiation proctitis (CRP) on endorectal ultrasound (ERUS) and investigate the value of ERUS in the evaluation of disease activity. 40 CRP patients and 30 control patients were investigated by ERUS. Rectal wall thickness and layers, ulcers and rectovaginal fistulas were evaluated by B-mode ultrasound. Power Doppler imaging was used to evaluate the vascularity of the rectal wall using a semiquantitative score. Disease activity was calculated according to the National Cancer Institute Common Terminology Criteria for Adverse Events 4...
July 26, 2017: Ultrasound in Medicine & Biology
Shyama Prem Sudha, D Kadambari
INTRODUCTION: Chronic radiation proctitis (CRP) usually develops 90 days or more after radiation. Currently, there is no standard available for the treatment of CRP. In argon plasma coagulation, monopolar diathermy is used to ionise the argon gas which coagulates the telengiectatic vessels in a noncontact fashion. However, there are very few studies which have reported its use in extensive CRP. We report the efficacy and safety of APC in seven patients with recurrent, extensive grade 3 radiation proctitis...
September 2017: International Journal of Colorectal Disease
Elodie Mintet, Jérémy Lavigne, Vincent Paget, Georges Tarlet, Valérie Buard, Olivier Guipaud, Jean-Christophe Sabourin, Maria-Luisa Iruela-Arispe, Fabien Milliat, Agnès François
The current study evaluated the role of Hey2 transcription factor in radiation-induced endothelial-to-mesenchymal transition (EndoMT) and its impact on radiation-induced tissue damage in mice. Phenotypic modifications of irradiated, Hey2 siRNA- and Hey2 vector plasmid-transfected human umbilical vein endothelial cells (HUVECs) resembling EndoMT were monitored by qPCR, immunocytochemistry and western blots. Subsequently, in mice, a Cre-LoxP strategy for inactivation of Hey2 specifically in the endothelium was used to study the biological consequences...
July 10, 2017: Scientific Reports
Q H Zhong, P H Wu, Q Y Qin, Y Y Kuang, T H Ma, H M Wang, Y X Zhu, D C Chen, J P Wang, L Wang
Objective: To investigate the effect of irradiation to anastomosis from preoperative radiotherapy for patients with rectal cancer by studying the pathological changes. Methods: In this retrospective study, patients enrolled in the FOWARC study from January 2011 to July 2014 in the Sixth Affiliated Hospital of Sun Yat-Sen University were included. In the FOWARC study, enrolled patients with local advanced rectal cancer were randomly assigned to receive either neoadjuvant chemo-radiotherapy or chemotherapy. Among these patients, 23 patients were selected as radiation proctitis (RP)group, who fulfilled these conditions: (1) received neoadjuvant chemo-radiotherapy followed by sphincter-preserving surgery; (2) developed radiation proctitis as confirmed by preoperative imaging diagnosis; (3) had intact clinical samples of surgical margins...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Adeleh Sahebnasagh, Arash Ghasemi, Jafar Akbari, Abbas Alipour, Hossein Lashkardoost, Shahram Ala, Ebrahim Salehifar
BACKGROUND: Acute radiation proctitis (ARP) is a common side-effect that affects up to 50% of patients receiving radiotherapy. The aim of this study was to evaluate the role of a topical preparation of Aloe vera in the treatment of ARP induced by radiotherapy of pelvic area. SUBJECTS AND INTERVENTIONS: In this double-blind placebo-controlled trial, 20 consecutive patients with ARP after external-beam radiation therapy (46-72 Gy) of pelvic malignancies were randomized to receive either Aloe vera 3% or placebo ointment, 1 g twice daily for 4 weeks...
November 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
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