Document Detail


Pathogenesis of acute radiation injury to the rectum. A prospective study in patients.
MedLine Citation:
PMID:  8027619     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a prospective investigation of the clinical and pathological effects of pelvic radiotherapy on the rectum, nine patients (age range 58-77 years) had symptoms assessed weekly during radical treatment for bladder and prostatic tumours, and at 2, 4 and 12 weeks after treatment. Stool frequency increased in all patients from a mean of 1.7 per day before treatment to 5.0 per day at 4 weeks (P < 0.05). Seven patients developed liquid stools during treatment; 6 had pain on defaecation, 8 had urgency of defaecation, all experienced tenesmus and 3 had episodes of faecal incontinence. One patient had symptoms of such severity that treatment was interrupted. Virtually all symptoms had resolved by 12 weeks after treatment. Sigmoidoscopy with biopsy of anterior and posterior rectal walls was performed before treatment began, at 2 weeks and 4 weeks during treatment, and 4 and 12 weeks after treatment. All patients during treatment had evidence of acute inflammatory damage with hyperaemic, oedematous mucosa and failure of healing of biopsy sites. Histological examination of the rectal biopsies revealed the well described characteristic mucosal changes with crypt cell damage, inflammatory cell infiltrate and loss of crypts. In 2 of 7 cases studied, pathology was still abnormal at 3 months. Radiation injury to bowel is an underemphasised cause of morbidity and further prospective studies are required to determine methods of reducing normal tissue damage and ameliorating symptoms.
Authors:
D M Sedgwick; G C Howard; A Ferguson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of colorectal disease     Volume:  9     ISSN:  0179-1958     ISO Abbreviation:  Int J Colorectal Dis     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-08-09     Completed Date:  1994-08-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8607899     Medline TA:  Int J Colorectal Dis     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  23-30     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Edinburgh, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Diarrhea / etiology
Female
Humans
Intestinal Mucosa / pathology,  ultrastructure
Male
Middle Aged
Nutrition Disorders / etiology
Pelvic Neoplasms / radiotherapy*
Prospective Studies
Radiation Injuries / complications*
Radiotherapy / adverse effects
Rectum / radiation effects*
Sigmoidoscopy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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