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Research ArticleClinical Studies

Clinical Outcome and Risk Factors of Chronic Radiation Proctitis Following Pelvic Radiation Therapy

CHAN-MUK IM, ICK-JOON CHO, HYUNG-JOO YU, BORA HAN, HYUNG-HOON OH, YOON-JIN SEO, KI-HYUN KIM, DAE-SEONG MYUNG, SUNG-BOM CHO, WAN-SIK LEE, TAEK-KEUN NAM and YOUNG-EUN JOO
Anticancer Research December 2022, 42 (12) 5951-5959; DOI: https://doi.org/10.21873/anticanres.16105
CHAN-MUK IM
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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ICK-JOON CHO
2Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
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HYUNG-JOO YU
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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BORA HAN
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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HYUNG-HOON OH
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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YOON-JIN SEO
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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KI-HYUN KIM
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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DAE-SEONG MYUNG
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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SUNG-BOM CHO
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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WAN-SIK LEE
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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TAEK-KEUN NAM
2Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
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YOUNG-EUN JOO
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;
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  • For correspondence: yejoo@chonnam.ac.kr
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Abstract

Background/Aim: Pelvic radiation therapy (RT) is a common treatment for malignancies, including gynecological, genitourinary, and lower gastrointestinal tract cancers. However, chronic radiation proctitis (RP) is an unavoidable side effect, and its clinical presentation varies from asymptomatic to potentially life-threatening. This study evaluated the clinical characteristics and risk factors of chronic RP. Patients and Methods: Patients with chronic RP (212) following RT for various pelvic cancers between January 2015 and December 2021 were enrolled. Clinical characteristics of RP were analyzed retrospectively. Severity was graded according to the Radiation Therapy Oncology Group (RTOG) modified rectal toxicity score and Vienna rectoscopy score (VRS), and risk factors were statistically analyzed. Results: The most common pelvic cancer observed was cervical cancer. The patients received three-dimensional conformal RT (3D-CRT), intensity-modulated RT, or a combination of 3D-CRT and intracavitary RT (ICR). Rectal bleeding occurred in 70 (33.0%) patients. Previous abdominopelvic surgery and total radiation dose significantly correlated with the RTOG score and VRS. Previous abdominopelvic surgery, ICR, and total radiation dose were associated with chronic hemorrhagic RP. All patients with chronic hemorrhagic RP were treated with argon plasma coagulation (APC). 91.4% of cases required 1-3 APC sessions to resolve the bleeding, with a mean of 1.7 sessions. Conclusion: Our results showed that previous abdominopelvic surgery and total radiation dose were significant risk factors related to chronic RP, while total radiation dose was related to chronic hemorrhagic RP. We also showed that APC was effective and safe for chronic hemorrhagic RP.

Key Words:
  • Radiation
  • proctitis
  • pelvis
  • cancer
  • Received September 15, 2022.
  • Revision received September 29, 2022.
  • Accepted October 6, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (12)
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Clinical Outcome and Risk Factors of Chronic Radiation Proctitis Following Pelvic Radiation Therapy
CHAN-MUK IM, ICK-JOON CHO, HYUNG-JOO YU, BORA HAN, HYUNG-HOON OH, YOON-JIN SEO, KI-HYUN KIM, DAE-SEONG MYUNG, SUNG-BOM CHO, WAN-SIK LEE, TAEK-KEUN NAM, YOUNG-EUN JOO
Anticancer Research Dec 2022, 42 (12) 5951-5959; DOI: 10.21873/anticanres.16105

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Clinical Outcome and Risk Factors of Chronic Radiation Proctitis Following Pelvic Radiation Therapy
CHAN-MUK IM, ICK-JOON CHO, HYUNG-JOO YU, BORA HAN, HYUNG-HOON OH, YOON-JIN SEO, KI-HYUN KIM, DAE-SEONG MYUNG, SUNG-BOM CHO, WAN-SIK LEE, TAEK-KEUN NAM, YOUNG-EUN JOO
Anticancer Research Dec 2022, 42 (12) 5951-5959; DOI: 10.21873/anticanres.16105
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