[The use of sucralfate in radiation oncology].
OBJECTIVE
Radiotherapy, a cornerstone in the management of head and neck cancer, pelvic cancer, and esophageal cancer is associated with a marked mucosal toxicity. Pain, malnutrition and diarrhea are the most prevalent clinical symptoms of radiation induced mucosal damage. Because there is no known way to obviate radiation mucositis all efforts to prevent aggravation and accelerate healing of mucosal changes are of great importance. Numerous agents including antimicrobials, local and systemic analgesics, antiinflammatory drugs, antidiarrheal drugs, in combination with intensive dietetic care are used to relieve symptoms. Recently coating agents like the polyaluminum-sucrose complex sucralfate were suggested for the prevention and treatment of mucosal reactions. Since sucralfate protects ulcerated epithelium by coating, liberates protective prostaglandins and increases the local availability of protective factors this drug might directly interact with the pathogenesis of mucositis.


METHODS
The results of available studies are analysed and discussed.


RESULTS
The results of several studies indicate that sucralfate treatment especially during radiotherapy for pelvic cancer leads to a significant amelioration of clinical symptoms and morphological changes. An application of sucralfate during radiotherapy of head and neck cancer reveals only limited benefits in most studies performed.


CONCLUSIONS
Nevertheless sucralfate is a safe, cheap and active drug for the prevention and treatment of radiation mucositis especially in patients with pelvic irradiation.
Belka
C
C
Abteilung für Strahlentherapie, Eberhard-Karls-Universität Tübingen.
Hoffmann
W
W
Paulsen
F
F
Barnberg
M
M
D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D009092:Mucous Membrane / Q000187:drug effects / Q000528:radiation effects; D010386:Pelvic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D011832:Radiation Injuries / Q000517:prevention & control; D018787:Radiation Oncology; D011837:Radiation-Protective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D013392:Sucralfate / Q000494:pharmacology / Q000627:therapeutic use*
D011837:Radiation-Protective Agents; D013392:Sucralfate