Radiation-induced rectal ulcer--prognostic factors and medical treatment.
OBJECTIVE
We conducted this study in order to investigate prognostic factors, and the difference of efficacy of three medical regimens, in the treatment of radiation-induced rectal ulcer.


METHODS
We enrolled 38 pts, with different ages, the free interval from radiation to the appearance of symptoms, and the rectal ulcer size. Medical regimens were 1) sucralfate enema, 2) salasopyrine + hydrocortisone enemas, 3) combination of regimens. We analyzed the difference of frequency of ulcer healing and the time necessary for ulcer healing, between the patients in the different groups.


RESULTS
The patients with late appearance of symptoms had significantly shorter time to ulcer healing than the patients with early appearance of symptoms (p=0.032). The patients who received sucralfate alone significantly more frequently achieved ulcer healing, than the patients with salasopyrine and hydrocortisone (p=0.046), and combination regimen (p=0.003). The patients with sucralfate (p=0.009), and with salasopyrine + hydrocortisone (p=0.0387), demanded significantly shorter time to ulcer healing than the patients who received combination treatment.


CONCLUSIONS
The free interval may be an important prognostic factor, in patients with rectal ulcer concerning treatment duration. It seems that treatment with sucralfate alone may be the treatment of choice, for patients with radiation-induced rectal ulcer.
Manojlovic
Nebojsa
N
Department of Gastroenterology and Endoscopy, Institute for Oncology and Radiology of Serbia, Belgrade, Yugoslavia. manojlovic@beotel.yu
Babic
Dragana
D
D000368:Aged; D000893:Anti-Inflammatory Agents; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D004733:Enema; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008875:Middle Aged; D010865:Pilot Projects; D011349:Proctitis / Q000188:drug therapy; D011379:Prognosis; D011832:Radiation Injuries / Q000188:drug therapy*; D013392:Sucralfate / Q000008:administration & dosage / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D000897:Anti-Ulcer Agents; D004338:Drug Combinations; D013392:Sucralfate; D006854:Hydrocortisone