Popromienne zapalenie błony śluzowej odbytnicy (PZBSO)

*Krzysztof Bielecki

Summary
Radiotherapy is one of the main methods of multidisciplinary treatment of cancer. Ionizing radiation causes deep changes to cancerous cells which leads to halting the cancer’s development or its destruction. Unfortunately, radiation damages neighbouring tissues.
Pelvic organs radiation results in radiation injury to the rectum. Radiation proctitis symptoms occur during the radiation treatment as well (acute radiation proctitis) or on average 24 months after the radiation treatment is completed. The incidence of proctitis is estimated at 20-60% of patients depending on the radiation dose used. Main symptoms include rectal haemorrhage, irregular stool passing combined with painful defecations and the urgent need to defecate. Diagnosing the syndrome is not simple. The treatment is based mainly on the treatment results in a number of patients. There are few controlled randomized studies pertaining to recommended treatment methods. Most patients are treated by conservative and pharmacological methods out of which the most effective ones include topical use of anti-inflammatory medications with/out metronidazole, steroids (hydrocortisone), sucralfate, pentoxyfiline with vit. A and E. In treatment refractory cases it is recommended to use endoscopy methods such as APC, RFA or the topical use of formalin. Argon plasma coagulation proves the most effective in haemorrhage control.
New radiation methods, the use of amifostine, hyaluronic acid or the so-called hydrogel spacer mitigate the risks of radiation proctitis.

To jest tylko fragment artykułu. Aby przeczytać całość, przejdź do Czytelni medycznej.