Sodium Butyrate Enemas in the Treatment of Acute Radiation-induced Proctitis in Patients with Prostate Cancer and the Impact on Late Proctitis. A Prospective Evaluation

Overview

Journal Strahlenther Onkol

Specialties Oncology
Radiology

Date 2008 Dec 25

PMID 19107351

Citations 17

Authors

Andrea Hille

Markus K A Herrmann

Tereza Kertesz

Hans Christiansen

Robert M Hermann

Olivier Pradier

Heinz Schmidberger

Clemens-F Hess

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate prospectively the effect of sodium butyrate enemas on the treatment of acute and the potential influence on late radiation-induced proctitis.

Patients And Methods: 31 patients had been treated with sodium butyrate enemas for radiation-induced acute grade II proctitis which had developed after 40 Gy in median. During irradiation the toxicity was evaluated weekly by the Common Toxicity Criteria (CTC) and subsequently yearly by the RTOG (Radiation Therapy Oncology Group) and LENT-SOMA scale.

Results: 23 of 31 patients (74%) experienced a decrease of CTC grade within 8 days on median. A statistical significant difference between the incidence and the severity of proctitis before start of treatment with sodium butyrate enemas compared to 14 days later and compared to the end of irradiation treatment course, respectively, was found. The median follow-up was 50 months. Twenty patients were recorded as suffering from no late proctitis symptom. Eleven patients suffered from grade I and 2 of these patients from grade II toxicity, too. No correlation was seen between the efficacy of butyrate enemas on acute proctitis and prevention or development of late toxicity, respectively.

Conclusion: Sodium butyrate enemas are effective in the treatment of acute radiation-induced proctitis in patients with prostate cancer but have no impact on the incidence and severity of late proctitis.

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References

Hovdenak N, Fajardo L, Hauer-Jensen M . Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy. Int J Radiat Oncol Biol Phys. 2000; 48(4):1111-7. DOI: 10.1016/s0360-3016(00)00744-6. View

Mortensen F, Nielsen H, Mulvany M, Hessov I . Short chain fatty acids dilate isolated human colonic resistance arteries. Gut. 1990; 31(12):1391-4. PMC: 1378763. DOI: 10.1136/gut.31.12.1391. View

Clausen M, Bonnen H, Tvede M, Mortensen P . Colonic fermentation to short-chain fatty acids is decreased in antibiotic-associated diarrhea. Gastroenterology. 1991; 101(6):1497-504. DOI: 10.1016/0016-5085(91)90384-w. View

Ardizzone S, Bianchi Porro G . The topical treatment of distal ulcerative colitis. Eur J Gastroenterol Hepatol. 1996; 8(6):599-602. DOI: 10.1097/00042737-199606000-00019. View

Gerstner N, Wachter S, Dorner D, Goldner G, Colotto A, Potter R . [Significance of a rectal balloon as internal immobilization device in conformal radiotherapy of prostatic carcinoma]. Strahlenther Onkol. 1999; 175(5):232-8. DOI: 10.1007/BF02742401. View

Kjellberg J, McPherson C, Murray C . Quality of life and treatment outcomes: prostate carcinoma patients' perspectives after prostatectomy or radiation therapy. Cancer. 1997; 79(10):1977-86. DOI: 10.1002/(sici)1097-0142(19970515)79:10<1977::aid-cncr20>3.0.co;2-r. View

DAmico A, Manola J, Loffredo M, Lopes L, NISSEN K, OFarrell D . A practical method to achieve prostate gland immobilization and target verification for daily treatment. Int J Radiat Oncol Biol Phys. 2001; 51(5):1431-6. DOI: 10.1016/s0360-3016(01)02663-3. View

Zelefsky M, Levin E, Hunt M, Yamada Y, Shippy A, Jackson A . Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2008; 70(4):1124-9. DOI: 10.1016/j.ijrobp.2007.11.044. View

. LENT SOMA scales for all anatomic sites. Int J Radiat Oncol Biol Phys. 1995; 31(5):1049-91. DOI: 10.1016/0360-3016(95)90159-0. View

10.

OBrien P, Franklin C, Dear K, HAMILTON C, Poulsen M, Joseph D . A phase III double-blind randomised study of rectal sucralfate suspension in the prevention of acute radiation proctitis. Radiother Oncol. 1998; 45(2):117-23. DOI: 10.1016/s0167-8140(97)00146-1. View

11.

Herbert S, Curran Jr W, Solin L, Stafford P, Lanciano R, Hanks G . Decreasing gastrointestinal morbidity with the use of small bowel contrast during treatment planning for pelvic irradiation. Int J Radiat Oncol Biol Phys. 1991; 20(4):835-42. DOI: 10.1016/0360-3016(91)90031-x. View

12.

Szepesi S, Jacobi V, Vecsei P, Bottcher H . [Treatment of radiogenic colitis with a rectal foam containing cortisol. Clinical and pharmacologic data]. Strahlenther Onkol. 1990; 166(4):271-4. View

13.

Pinkawa M, Siluschek J, Gagel B, Piroth M, Demirel C, Asadpour B . Postoperative radiotherapy for prostate cancer : evaluation of target motion and treatment techniques (intensity-modulated versus conformal radiotherapy). Strahlenther Onkol. 2007; 183(1):23-9. DOI: 10.1007/s00066-007-1588-2. View

14.

Trotti A, Byhardt R, Stetz J, Gwede C, Corn B, Fu K . Common toxicity criteria: version 2.0. an improved reference for grading the acute effects of cancer treatment: impact on radiotherapy. Int J Radiat Oncol Biol Phys. 2000; 47(1):13-47. DOI: 10.1016/s0360-3016(99)00559-3. View

15.

BREUER R, SOERGEL K, Lashner B, Christ M, Hanauer S, Vanagunas A . Short chain fatty acid rectal irrigation for left-sided ulcerative colitis: a randomised, placebo controlled trial. Gut. 1997; 40(4):485-91. PMC: 1027123. DOI: 10.1136/gut.40.4.485. View

16.

Michalski J, Purdy J, Winter K, Roach 3rd M, Vijayakumar S, Sandler H . Preliminary report of toxicity following 3D radiation therapy for prostate cancer on 3DOG/RTOG 9406. Int J Radiat Oncol Biol Phys. 2000; 46(2):391-402. DOI: 10.1016/s0360-3016(99)00443-5. View

17.

Weiss E, Hirnle P, Hess C, Bamberg M . Therapeutic outcome and relation of acute and late side effects in the adjuvant radiotherapy of endometrial carcinoma stage I and II. Radiother Oncol. 2000; 53(1):37-44. DOI: 10.1016/s0167-8140(99)00120-6. View

18.

Vernia P, Fracasso P, Casale V, Villotti G, Marcheggiano A, Stigliano V . Topical butyrate for acute radiation proctitis: randomised, crossover trial. Lancet. 2000; 356(9237):1232-5. DOI: 10.1016/s0140-6736(00)02787-2. View

19.

Cox J, Stetz J, Pajak T . Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995; 31(5):1341-6. DOI: 10.1016/0360-3016(95)00060-C. View

20.

Elsayed H, Bolling T, Moustakis C, Muller S, Schuller P, Ernst I . Organ movements and dose exposures in teletherapy of prostate cancer using a rectal balloon. Strahlenther Onkol. 2007; 183(11):617-24. DOI: 10.1007/s00066-007-1736-8. View