Pelvic radiation disease (part 3): identification, investigations, findings and management

Symptoms that develop following pelvic radiotherapy have become known as pelvic radiation disease (PRD). This article describes the common underlying gastrointestinal pathologies related to PRD and suggests ways to identify and investigate patients. Scoring systems available to support identification of people with possible PRD can be complex and time-consuming. The Assessment of Late Effects of Radiotherapy-Bowel (ALERT-B) tool, in which a positive answer triggers further enquiry, is simple and quick to use. A guideline document on the practical management of the gastrointestinal symptoms of PRD suggests a stepwise approach to both investigate and treat the symptoms.

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Guidance: The practical management of the gastrointestinal symptoms of pelvic radiation disease

Frontline Gastroenterology ◽

10.1136/flgastro-2014-100468 ◽

2014 ◽

Vol 6 (1) ◽

pp. 53-72 ◽

Cited By ~ 39

Author(s):

H Jervoise N Andreyev ◽

Ann C Muls ◽

Christine Norton ◽

Charlotte Ralph ◽

Lorraine Watson ◽

...

Keyword(s):

Gastrointestinal Symptoms ◽

Pelvic Radiation ◽

Practical Management

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OC-0318 A novel eLearning tool for ongoing radiation therapist education on pelvic radiotherapy late effects

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)06865-1 ◽

2021 ◽

Vol 161 ◽

pp. S227-S228

Author(s):

M. Kirby ◽

L. Oliver ◽

L. Kind ◽

B. Porritt

Keyword(s):

Late Effects ◽

Pelvic Radiotherapy ◽

Radiation Therapist ◽

Therapist Education

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Can Nurses Manage Gastrointestinal Symptoms Arising from Pelvic Radiation Disease?

Clinical Oncology ◽

10.1016/j.clon.2011.03.006 ◽

2011 ◽

Vol 23 (8) ◽

pp. 538-551 ◽

Cited By ~ 14

Author(s):

B. Benton ◽

C. Norton ◽

J.O. Lindsay ◽

S. Dolan ◽

H.J.N. Andreyev

Keyword(s):

Gastrointestinal Symptoms ◽

Pelvic Radiation

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Patients' Perspectives of the Impact of Gastrointestinal Symptoms after Pelvic Radiotherapy

Clinical Oncology ◽

10.1016/j.clon.2006.03.010 ◽

2006 ◽

Vol 18 (5) ◽

pp. 423 ◽

Cited By ~ 1

Author(s):

C. Goode ◽

C. Gillespie ◽

C. Hackett ◽

J. Andreyev

Keyword(s):

Gastrointestinal Symptoms ◽

Pelvic Radiotherapy ◽

The Impact

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The Symptoms and Medications of Patients with Inflammatory Bowel Disease in Hubei Province after COVID-19 Epidemic

Journal of Immunology Research ◽

10.1155/2020/2847316 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Huan Wang ◽

Lei Tu ◽

Ying Li ◽

Tao Bai ◽

Kaifang Zou ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Online Survey ◽

Gastrointestinal Symptoms ◽

Life Quality ◽

Scoring Systems ◽

Hubei Province ◽

Depression And Anxiety ◽

Psychological Issues ◽

Inflammatory Bowel

Objectives. The COVID-19 epidemic triggered by coronavirus SARS-CoV-2 is rapidly spreading around the globe. This study is aimed at finding out the suspected or confirmed SARS-CoV-2 infection in patients with inflammatory bowel disease (IBD) in Hubei province, China. We also investigated symptoms, medications, life quality, and psychological issues of IBD patients under the ongoing pandemic. Methods. We conducted a self-reported questionnaire survey via an online survey platform. SARS-CoV-2 infection-related data was collected from IBD patients. The status quo of medications and symptoms of the subjects were investigated. Life quality, depression, and anxiety were measured by clinical questionnaires and rated on scoring systems. Results. A total of 204 IBD patients from Hubei province were included in this study. No suspected or confirmed SARS-CoV-2 infection case was found in this study. As a result of city shutdown, two-thirds of the patients (138/204) in our series reported difficulty in accessing medicines and nearly half of them (73/138) had to discontinue medications. Apart from gastrointestinal symptoms, systemic symptoms were common while respiratory symptoms were rare in the cohort. Though their quality of life was not significantly lowered, depression and anxiety were problems that seriously affected them during the COVID-19 epidemic. Conclusions. Inaccessibility to medications is a serious problem for IBD patients after city shutdown. Efforts have to be made to address the problems of drug withdrawal and psychological issues that IBD patients suffer from during the COVID-19 outbreak.

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Gastrointestinal symptoms of pelvic radiation disease (part 1): literature review

Gastrointestinal Nursing ◽

10.12968/gasn.2020.18.2.40 ◽

2020 ◽

Vol 18 (2) ◽

pp. 40-45 ◽

Cited By ~ 1

Author(s):

Helen Ludlow ◽

John Green

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Literature Review ◽

Patient Experience ◽

Gastrointestinal Symptoms ◽

Pelvic Radiation ◽

Gi Symptoms ◽

Pelvic Cancer ◽

The Impact

Radiotherapy used to treat cancers in the pelvic region can have lasting side effects, and the persistence of these symptoms for 3 months or more is described as pelvic radiation disease (PRD). The growing number of pelvic cancer patients being diagnosed and successfully treated is increasing the incidence of PRD. This review examines the literature on the gastrointestinal symptoms of PRD. This includes how PRD is defined, how it is identified and how it relates specifically to the three pelvic cancers in which it most commonly manifests (prostate, gynaecological and colorectal). It pays particular attention to the impact of PRD on patient experience and quality of life. This review is the first part in a series on the GI symptoms of PRD.

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Acute Skin Damage and Late Radiation-Induced Fibrosis and Inflammation in Murine Ears after High-Dose Irradiation

Cancers ◽

10.3390/cancers11050727 ◽

2019 ◽

Vol 11 (5) ◽

pp. 727 ◽

Cited By ~ 3

Author(s):

Annique C. Dombrowsky ◽

Jannis Schauer ◽

Matthias Sammer ◽

Andreas Blutke ◽

Dietrich W. M. Walsh ◽

...

Keyword(s):

Transforming Growth Factor Beta ◽

Late Effects ◽

Transforming Growth Factor ◽

Scoring Systems ◽

High Dose ◽

Skin Damage ◽

Fractional Dose ◽

Radiation Induced ◽

Tissue Alterations ◽

Dose Dependent

The use of different scoring systems for radiation-induced toxicity limits comparability between studies. We examined dose-dependent tissue alterations following hypofractionated X-ray irradiation and evaluated their use as scoring criteria. Four dose fractions (0, 5, 10, 20, 30 Gy/fraction) were applied daily to ear pinnae. Acute effects (ear thickness, erythema, desquamation) were monitored for 92 days after fraction 1. Late effects (chronic inflammation, fibrosis) and the presence of transforming growth factor beta 1 (TGFβ1)-expressing cells were quantified on day 92. The maximum ear thickness displayed a significant positive correlation with fractional dose. Increased ear thickness and erythema occurred simultaneously, followed by desquamation from day 10 onwards. A significant dose-dependency was observed for the severity of erythema, but not for desquamation. After 4 × 20 and 4 × 30 Gy, inflammation was significantly increased on day 92, whereas fibrosis and the abundance of TGFβ1-expressing cells were only marginally increased after 4 × 30 Gy. Ear thickness significantly correlated with the severity of inflammation and fibrosis on day 92, but not with the number of TGFβ1-expressing cells. Fibrosis correlated significantly with inflammation and fractional dose. In conclusion, the parameter of ear thickness can be used as an objective, numerical and dose-dependent quantification criterion to characterize the severity of acute toxicity and allow for the prediction of late effects.

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