The team conducted a systematic review of the non-surgical treatment options for the management of late chronic radiation proctitis.
They reported their findings in the latest issue of the British Journal of Cancer.
Currently, there is no recommended standard management for this condition.
A range of databases was searched for synonyms for radiation therapy and for the spectrum of lower gastrointestinal radiation toxicity.
The included studies were those that involved interventions for the non-surgical management of late radiation proctitis.
A total of 63 studies were identified that met the inclusion criteria, including 6 randomized controlled trials.
|63 studies of non-surgical management of late radiation proctitis identified.
| British Journal of Cancer |
These described the effects of anti-inflammatory agents in combination, rectal steroids alone, rectal sucralfate, short chain fatty acid enemas, and different types of thermal therapy.
However, the authors found that these studies could not be compared.
They note that, if the management of late radiation proctitis is to become evidence-based, then, in view of its episodic and variable nature, placebo controlled studies need to be conducted to clarify which therapeutic options should be recommended.
From the current data, certain interventions look promising and may be effective.
However, one small or modest sized study, even if well conducted, is insufficient to implement changes in practice.
In order to increase recruitment to trials, a national register of cases with established late radiation toxicity is required. This would facilitate multicenter trials with specific entry criteria, formal baseline, and therapeutic assessments, providing standardized outcome data, the researchers concluded.