Late gastrointestinal complications after pelvic radiotherapy: radiation enteritis.
BACKGROUND
Radiation enteritis is a complication of radiation therapy for pelvic tumours. It appears after a variable period of time and is often progressive.


METHODS
We analyse our experience of 77 cases (52 females and 25 males) diagnosed with radiation enteritis or proctitis between 1986 and 2006.


RESULTS
The most frequent location of radiation injury is ileum (55 patients, 71%), followed by rectum (22 patients, 28%). Twenty-eight patients (36%) were medically managed and 49 (64%) required surgical treatment. In 41 (53%) of the patients the affected region was resected, in 5 (7%) a by-pass was performed and in 3 (4%) a terminal colostomy. Surgical mortality was 4% (3 cases) and the complication rate 9% (7 cases). Twelve patients (16%) presented recurrence of radiation-related illness. Excluding those cases deceased because of tumoral progression, 5-year survival rate was 90% and 10-year survival rate 83%.


CONCLUSIONS
Radiation enteritis must be initially conservatively managed, but in those cases without response, surgery is indicated. Surgical treatment should not be delayed fearing postoperative complications, which are more susceptible to appear in deteriorated patients. If technically possible, the affected region should be resected, because complications may appear later at this damaged location.
Ruiz-Tovar
Jaime
J
Department of Surgery, University Hospital Ramón y Cajal, Madrid, Spain. jruiztovar@gmail.com
Morales
Vicente
V
Hervás
Asunción
A
Sanjuanbenito
Alfonso
A
Lobo
Eduardo
E
Martínez-Molina
Enrique
E
D004751:Enteritis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010386:Pelvic Neoplasms / Q000150:complications / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects