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e-mail: [email protected] J Babol Univ Med Sci; 11(3); Aug-Sep 2009 The Effect of Sucralfate in Prevention ; N. Ahmadloo, et al RTOG/ EORTC
Kneebone, Martenson J Babol Univ Med Sci; 11(3); Aug-Sep 2009 The Effect of Sucralfate in Prevention ; N. Ahmadloo, et al The Effect of Sucralfate in Prevention of Radiation- Induced
Acute Proctitis
N. Ahmadloo (MD) 1, L. Kasraian (MD) 2, M. Mohammadian Panah (MD) 1 ,
S. Omidvari (MD) 1, A. Mosalaei (MD) 3
1. Associate Professor of Radiotherapy & Oncology, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran 2. Assistant Professor of Social Medicine, Member of Blood Transfusion Research Center of Tehran, Shiraz University of Medical Sciences, Shiraz, Iran 3. Professor of Radiotherapy & Oncology, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran Received: Dec 2nd 2008, Revised: Feb 18th 2009, Accepted: May 12th 2009.
ABSTRACT
BACKGROUND AND OBJECTIVE: Acute proctitis is a common, disturbing side effect of pelvic irradiation that
might interrupt treatment. To decrease or prevention of these side effects many drugs were used but no effective treatment was found. The aim of this study was to evaluate the efficacy of sucralfate for possible reduction of radiation-induced lower GI toxicities. METHODS: In this clinical trial study 100 patients that required curative pelvic radiation therapy were randomly
divided into two groups. Group one received 3g oral sucralfate and group two received placebo as control. All patients were given at least 50 Gy external-beam irradiation. Their bowel symptoms that include diarrhea, abdominal pain or distention, mucous or bloody discharge, obstruction or perforation were scored according to the RTOG/EORTC acute toxicity criteria. Desquamation and duration of treatment interruption were studied in both FINDINGS: From cases, there were 49 cases in group one and 47 cases in group two and 4 cases were excluded
from study. The two groups were statistically the same according to sex, age, anatomopathology and radiation therapy parameters. Comparing acute lower GI toxicities, desquamation and duration of treatment interruption, there were no statistically significant differences between the two groups. No acute lower GI toxicities were seen in 18 cases from group one and 10 cases from group two. No grade 4 lower GI toxicities were seen in patients. CONCLUSION: In our study, there was no clinical evidence that oral sucralfate ameliorates radiation-induced
proctitis. Therefore, sucralfate as a routine prophylactic agent is not suggested in pelvic radiation therapy and further investigations are generally needed to find out the efficacy of sucralfate in radiation-induced GI toxicities. KEY WORDS: Sucralfate, Pelvic radiotherapy, Proctitis.
Corresponding Author;
Address: Radiotherapy & Oncology, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran
E-mail: [email protected]
References
1. Fowler JF, Lindstrom MJ. Loss of local control with prolongation in radiotherapy. Int J Radiat Oncol Biol Phys 1992; 23(2): 457-63. 2. Harari PM, Fowler JF. Idealized versus realized overall treatment times. Int J Radiat Oncol Biol Phys 1994; 29(1): 3. Bentzen SM. Towards evidence based radiation oncology: improving the design, analysis, and reporting of clinical outcome studies in radiotherapy. Radiat Oncol 1998; 46(1): 5-18. 4. Smalley SR, Evans RG. Radiation morbidity to the gastrointestinal tract and liver. In: Plowman P, McElwain T, Meadows A, eds. Complications of cancer management. Oxford, England: Butterworth Heinemann 1991; pp: 276-9. 5. O Brien PC, Franklin CI, Dear KB, et al. A phase III double blind randomised study of rectal sucralfate suspension in the prevention of acute radiation proctitis. Radiother Oncol 1997; 45(2): 117-23. 6. Etiz D, Erkal HS, Serin M, et al. Clinical and histopathological evaluation of sucralfate in prevention of oral mucositis induced by radiation therapy in patients with head and neck malignancies. Oral Oncol 2000; 36(1): 116-20. 7. Shenep JL, Kalwinsky DK, Hutson PR, et al. Efficacy of oral sucralfate suspension in prevention and treatment of chemotherapy-induced mucositis. J Pediatr 1988; 113(4): 758-63. 8. Pfeiffer P, Madsen EL, Hansen O, May O. Effect of prophylactic sucralfate suspension on stomatitis induced by cancer chemotherapy: a randomized, double-blind cross-over study. Acta Oncol 1990; 29(2): 171-3. 9. Henriksson R, Franzen L, Littbrand B. Effects of sucralfate on acute and late bowel discomfort following radiotherapy of pelvic cancer. J Clin Oncol 1992; 10(6): 969-75. 10. Sur PK, Kochhar R, Singh DP. Oral sucralfate in acute radiation oesophagitis. Acta Oncol 1994; 33(1): 61-3. 11. Szabo S, Vattay P, Scarough E, Folkman J. Role of vascular factors including angiogenesis in the mechanism of action of sucralfate. Am J Med 1991; 91(2A): 158-60. 12. Brooks WS. Sucralfate: nonulcer uses. American college of gastroenterology committee on FDA-related matters. Am J Gastroenterol 1995; 80(3): 206-9. 13. McCarthy DM. Sucralfate. N Engl J Med 1991; 325(14): 1017-25. 14. Tarnawski A, Hollander D, Krause WJ, Zipser RD, Stachura J, Gergely H. Does sucralfate affect the normal gastric mucosa? Histologic, ultrastructural, and functional assessment in the rat. Gastroenterology 1986; 90(4): 893-905. 15. Burch RM, McMillan BA. Sucralfate induces proliferation of dermal fibroblasts and keratinocytes in culture and granulation tissue formation in full thickness skin wounds. Agents Actions 1991; 34(1-2): 229-31. 16. Szabo S, Hollander D. Pathways of gastrointestinal protection and repair: Mechanisms of action of sucralfate. Am J Med 1989; 86(6A): 23-31. 17. Sanguineti G, Franzone P, Marcenaro M, Foppiano F, Vitale V. Sucralfate versus mesalazine versus hydrocortisone in the prevention of acute radiation proctitis during conformal radiotherapy for prostate carcinoma. A randomized study. Strahlenther Onkol 2003; 179(7): 464-70. 18. Hovdenak N, Sorbye H, Dahl O. Sucralfate does not ameliorate acute radiation proctitis: randomised study and meta-analysis. Clin Oncol (R Coll Radiol) 2005; 17(6): 485-91. 19. Mor V, Laliberte L, Morris JN, Wiemann M. The Karnofsky performance status scale. An examination of its reliability and validity in a research setting. Cancer 1984; 53(9): 2002-7. 20. Cox JD, Stetz J, Pajak TF. Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radial Oncol Biol Phys 1995; 31(5): 1341-6. 21. Kneebone A, Mameghan H, Bolin T, et al. The effect of oral sucralfate on the acute proctitis associated with prostate radiotherapy: A double- blind randomized trial. Int J Radiat Oncol Biol Phys 2001; 51(30): 628-35. J Babol Univ Med Sci; 11(3); Aug-Sep 2009 The Effect of Sucralfate in Prevention ; N. Ahmadloo, et al 22. Valls A, Pestchen I , Prats C, et al. Multicenter double blind clinical trial comparing sucralfate vs placebo in the prevention of diarrhea secondary to pelvic irradiation. Med Clin (Barc) 1999; 113(18): 681-4. 23. Martenson JA, Bollinger JW, Sloan JA, et al. Sucralfate in the prevention of treatment induced diarrhea in patients receiving pelvic radiation therapy: A North Central Cancer Treatment Group phase III double blind placebo controlled trial. J Clin Oncol 2000; 18(6): 1239-45. 24. Manojlovic N, Babic D. Radiation-induced rectal ulcer--prognostic factors and medical treatment. Hepatogastroenterology 2004; 51(56): 447-50. 25. Gul YA, Prasannan S, Jabar FM, Shaker AR, Moissinac K. Pharmacotherapy for chronic hemorrhagic radiation proctitis. World J Surg 2002; 26(12): 1499-502.

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