To evaluate the efficacy and safety of Qing Dai (indigo naturalis), a traditional Chinese medicine, in the treatment for chronic hemorrhagic radiation proctitis.
Ten patients with chronic hemorrhagic radiation proctitis between January 2005 to January 2008 were treated with Qing Dai. Qing Dai was administered orally at a dose of 1.5 g, bid for 5 consecutive days, every 2 weeks for two courses. Patients were followed up every 3 months. The clinical response and side-effects were evaluated.
Six patients showed improvement of rectal bleeding to grade 0–1 after 1 course of Qing Dai therapy. Four patients had reduced rectal bleeding to grade 0–1 after 2 courses of the therapy. The median follow-up time was 10 months (range: 6–24). During the follow-up period, 1 patient experienced recurrent rectal bleeding and was managed with topical formalin dabbing, which controlled the symptom. No treatment toxicity was observed.
Qing Dai may be a safe and effective treatment for chronic hemorrhagic radiation proctitis.
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Hayne D, Vaizey CJ, Boulos PB. Anorectal injury following pelvic radiotherapy. Br J Surg, 2001, 88: 1037–1048.
Babb RR. Radiation proctitis: a review. Am J Gastroenterol, 1996, 91: 1309–1311.
Cotti G, Seid V, Araujo S, et al. Conservative therapies for hemorrhagic radiation proctitis: a review. Rev Hosp Clin Fac Med Sao Paulo, 2003, 58: 284–292.
de Parades V, Etienney I, Bauer P, et al. Formalin application in the treatment of chronic radiation-induced hemorrhagic proctitis-an effective but not risk-free procedure: a prospective study of 33 patients. Dis Colon Rectum, 2005, 48: 1535–1541.
Viggiano TR, Zighelboim J, Ahlquist DA, et al. Endoscopic Nd: YAG laser coagulation of bleeding from radiation proctopathy. Gastrointest Endosc, 1993, 39: 513–517.
Büyükberber M, Savaş MC, Gülşen MT, et al. Argon plasma coagulation in the treatment of hemorrhagic radiation proctitis. Turk J Gastroenterol, 2005, 16: 232–235.
Kunikata T, Tatefuji T, Aga H, et al. Indirubin inhibits inflammatory reactions in delayed-type hypersensitivity. Eur J Pharmacol, 2000, 410: 93–100.
Eisenbrand G, Hippe F, Jakobs S, et al. Molecular mechanisms of indirubin and its derivatives: novel anticancer molecules with their origin in traditional Chinese phytomedicine. J Cancer Res Clin Oncol, 2004, 130: 627–635.
Coia LR, Myerson RJ, Tepper JE. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys, 1995, 31: 1213–1236.
Gul YA, Prasannan S, Jabar FM, et al. Pharmacotherapy for chronic hemorrhagic radiation proctitis. World J Surg, 2002, 26: 1499–1502.
Jones K, Evans AW, Bristow RG, et al. Treatment of radiation proctitis with hyperbaric oxygen. Radiother Oncol, 2006, 78: 91–94.
Mak NK, Leung CY, Wei XY, et al. Inhibition of RANTES expression by indirubin in influenza virus-infected human bronchial epithelial cells. Biochem Pharmacol, 2004, 67: 167–174.
Sethi G, Ahn KS, Sandur SK, et al. Indirubin enhances tumor necrosis factor-induced apoptosis through modulation of nuclear factor-kappa B signaling pathway. J Biol Chem, 2006, 281: 23425–23435.
Veerasarn V, Boonnuch W, Kakanaporn C. A phase II study to evaluate WF10 in patients with late hemorrhagic radiation cystitis and proctitis. Gynecol Oncol, 2006, 100: 179–184.
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Yuan, G., Ke, Q., Su, X. et al. Qing Dai, a traditional Chinese medicine for the treatment of chronic hemorrhagic radiation proctitis. Chin. -Ger. J. Clin. Oncol. 8, 114 (2009). https://doi.org/10.1007/s10330-008-0141-9
- chronic radiation proctitis
- rectal bleeding
- Qing Dai