Medical management of radiation effects on the intestines

Abstract

Despite advances in the delivery of pelvic radiotherapy, radiation-related injuries of the small and large intestines remain one of the most prominent acute and chronic toxicities of treatment. Management of acute toxicity is mainly symptomatic. Options for chronic radiation enteropathy include low-residue diet, nutritional supplementation, hyperbaric oxygen (HBO) therapy, and total parenteral nutrition. Chronic radiation proctopathy can be managed using either nonendoscopic methods including sucralfate enemas, oral vitamin A and HBO therapy, and/or endoscopic methods for rectal bleeding, including bipolar electrocautery, heater probe, and argon plasma coagulation. Several preventive options are available, including amifostine, a scavenger of radiation-induced free radicals.