Agne Sipaviciute1, Ernestas Sileika2, Arvydas Burneckis2, Audrius Dulskas3,4,5. 1. Faculty of Medicine, Vilnius University, Vilnius, Lithuania. 2. Department of Radiotherapy, National Cancer Institute, 1 Santariskiu Str., LT-08406, Vilnius, Lithuania. 3. Department of Abdominal and General Surgery and Oncology, National Cancer Institute, 1 Santariskiu Str., LT-08406, Vilnius, Lithuania. audrius.dulskas@gmail.com. 4. Faculty of Health Care, University of Applied Sciences, 45 Didlaukio Str., LT-08303, Vilnius, Lithuania. audrius.dulskas@gmail.com. 5. Department of Abdominal and General Surgery and Oncology, National Cancer Institute, Clinic of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, 1 Santariskiu Str., LT-08406, Vilnius, Lithuania. audrius.dulskas@gmail.com.
Abstract
PURPOSE: Although the multimodal cancer treatment techniques have greatly improved over the years, irradiation-induced late gastrointestinal toxicity remains a great concern as it may highly affect the quality of life of a patient. The aim of this study was to define the prevalence of late gastrointestinal toxicities. METHODS: Electronic databases of Cochrane Library, Embase, Web of Science, CENTRAL and PubMed were searched until September 2019. We used the following keywords: radiotherapy, radiation therapy, irradiation, rectal cancer, gastrointestinal toxicity, adverse effects, late effects, pelvic radiation and pelvic radiation disease. RESULTS: Nine studies were included into this review out of 4785 that were preidentified as potentially relevant. Overall prevalence of severe (Grade 3 or higher) late irradiation-induced gastrointestinal toxicities was up to 19%. Most frequent toxicities of any grade were reported to be diarrhoea (up to 35%), faecal incontinence (22%), incontinence to gas (71%), rectal bleeding (9%), rectal pain (13%) and obstruction (7.4%). Preoperative treatment approaches and more advance radiotherapy techniques such as intensity-modulated and image-guided radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) turn out to result in lower late gastrointestinal toxicity rates. CONCLUSION: After great improvements in rectal cancer treatment, late gastrointestinal toxicity after radiotherapy is experienced less frequent and less severe; however, it remains a great concern associated with worse quality of life.
PURPOSE: Although the multimodal cancer treatment techniques have greatly improved over the years, irradiation-induced late gastrointestinal toxicity remains a great concern as it may highly affect the quality of life of a patient. The aim of this study was to define the prevalence of late gastrointestinal toxicities. METHODS: Electronic databases of Cochrane Library, Embase, Web of Science, CENTRAL and PubMed were searched until September 2019. We used the following keywords: radiotherapy, radiation therapy, irradiation, rectal cancer, gastrointestinal toxicity, adverse effects, late effects, pelvic radiation and pelvic radiation disease. RESULTS: Nine studies were included into this review out of 4785 that were preidentified as potentially relevant. Overall prevalence of severe (Grade 3 or higher) late irradiation-induced gastrointestinal toxicities was up to 19%. Most frequent toxicities of any grade were reported to be diarrhoea (up to 35%), faecal incontinence (22%), incontinence to gas (71%), rectal bleeding (9%), rectal pain (13%) and obstruction (7.4%). Preoperative treatment approaches and more advance radiotherapy techniques such as intensity-modulated and image-guided radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) turn out to result in lower late gastrointestinal toxicity rates. CONCLUSION: After great improvements in rectal cancer treatment, late gastrointestinal toxicity after radiotherapy is experienced less frequent and less severe; however, it remains a great concern associated with worse quality of life.
Entities:
Keywords:
Late gastrointestinal toxicity; Quality of life; Radiotherapy; Rectal cancer
Authors: Dong-Ming Wu; Jing Li; Rong Shen; Jin Li; Ye Yu; Li Li; Shi-Hua Deng; Teng Liu; Ting Zhang; Ying Xu; De-Gui Wang Journal: Front Pharmacol Date: 2022-01-18 Impact factor: 5.810