Digestive Diseases and Sciences

, Volume 56, Issue 9, pp 2672–2677

The Efficacy of the Combination Therapy with Oral and Topical Mesalazine for Patients with the First Episode of Radiation Proctitis

  • Eun Hee Seo
  • Tae Oh Kim
  • Tae Gyoon Kim
  • Hee Rin Joo
  • Jongha Park
  • Seung Ha Park
  • Sung Yeon Yang
  • Young Soo Moon
  • Min Jae Park
  • Dong Yup Ryu
  • Geun Am Song
Original Article

DOI: 10.1007/s10620-011-1637-7

Cite this article as:
Seo, E.H., Kim, T.O., Kim, T.G. et al. Dig Dis Sci (2011) 56: 2672. doi:10.1007/s10620-011-1637-7

Abstract

Background/Aims

Radiation proctitis is a common complication of pelvic radiation for which an optimal treatment remains undetermined. We assessed the efficacy of oral and topical mesalazine combination therapy for patients with naive radiation proctitis.

Methods

A total of 23 patients with radiation proctitis were enrolled in the study over a period of 2 years. Three of these patients were excluded due to severe bleeding during the study. Twenty patients (mean age 60.3 years; two males, 18 females) were treated with oral mesalazine (3 × 1 g per day) plus a daily mesalazine suppository (1 g per day at bedtime) for 4 weeks. The efficacy of treatment was assessed according to the Subjective Objective Management Analytic (SOMA) scale for alleviation of clinical symptoms of rectal toxicity and sigmoidoscopic findings.

Results

The mean bleeding score improved significantly from 2.10 to 1.70 (p = 0.002) with mesalazine treatment. However, scores were not improved for pain (0.30–0.20, p = 0.163), tenesmus (0.50–0.45, p = 0.577), or stool frequency (0.35–0.30, p = 0.577). The improvements in the mean telangiectasia score (1.80–1.45, p = 0.005), bleeding point score (1.60–1.05, p < 0.001), and friable mucosa score (1.35–1.00, p = 0.005) were all statistically significant. No side-effects were noted in any of the patients.

Conclusions

The combination of oral and topical mesalazine therapy for radiation proctitis may be a safe and effective treatment for naive radiation proctitis, especially for hemorrhagic proctitis. A large, randomized controlled trial is required to confirm the results of this pilot study.

Keywords

Radiation proctitisColonoscopy5-ASAEfficacy

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Eun Hee Seo
    • 1
  • Tae Oh Kim
    • 1
  • Tae Gyoon Kim
    • 1
  • Hee Rin Joo
    • 1
  • Jongha Park
    • 1
  • Seung Ha Park
    • 1
  • Sung Yeon Yang
    • 1
  • Young Soo Moon
    • 1
  • Min Jae Park
    • 1
  • Dong Yup Ryu
    • 2
  • Geun Am Song
    • 2
  1. 1.Departments of Internal Medicine, Haeundae Paik HospitalInje University School of MedicineBusanRepublic of Korea
  2. 2.Department of Internal MedicinePusan National University School of MedicineBusanRepublic of Korea