RADIATION PROCTITIS - CLINICAL AND PATHOLOGICAL MANIFESTATIONS, THERAPY AND PROPHYLAXIS OF ACUTE AND LATE INJURIOUS EFFECTS OF RADIATION ONTHE RECTAL MUCOSA

Background: Often the rectum is the dose-limiting organ in curative ra diation therapy of pelvic malignancies. It reacts with serous, mucoid, or more rarely bloody diarrhea. Methods: A research for reports on pr ophylactic and supportive therapies of radiation-induced proctitis was performed (Medline, Cancerlit, and others). Results: No proven effect ive prophylactic local or systemic therapies of radiation proctitis ex ist. Also, no reasonable causal medication is known. In the treatment of late radiation sequelae no clincally tested certain effective thera py exists, too. Antiinflammatory, steroidal or non-steroidal therapeut ics as well as sucralfate can be used as topical measures. They will b e successful in some patients. Side effects are rare and the therapy i s cost-effective. Treatment failures can be treated by hyperbaric oxyg en. This will achieve good clinical results in about 50% of the cases. Single or few mucosal telangiectasias with rectal bleeding can be tre ated sufficiently by endoscopic cautherization.Conclusion: Besides cli nical studies acute proctitis should be treated just symptomatically. Radical surgery should be performed only when all conventional treatme nts have been uneffective, although no certain effective therapies of radiation-induced late proctitis exist.