title: The efficacy of the combination therapy with oral and topical mesalazine for patients with the first episode of radiation proctitis.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Internal Medicine, Haeundae Paik Hospital, Inje University School of Medicine, 1435 Jwa-dong, Haeundae-gu, Busan 612-030, Republic of Korea.
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Seo
authors.forename: Tae Oh
authors.initials: TO
authors.lastname: Kim
authors.forename: Tae Gyoon
authors.initials: TG
authors.lastname: Kim
authors.forename: Hee Rin
authors.initials: HR
authors.lastname: Joo
authors.forename: Jongha
authors.initials: J
authors.lastname: Park
authors.forename: Seung Ha
authors.initials: SH
authors.lastname: Park
authors.forename: Sung Yeon
authors.initials: SY
authors.lastname: Yang
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Moon
authors.forename: Min Jae
authors.initials: MJ
authors.lastname: Park
authors.forename: Dong Yup
authors.initials: DY
authors.lastname: Ryu
authors.forename: Geun Am
authors.initials: GA
authors.lastname: Song
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage* / Q000627:therapeutic use*; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000532:radiotherapy; D011349:Proctitis / Q000209:etiology*; D011832:Radiation Injuries / Q000188:drug therapy*; D013488:Suppositories
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013488:Suppositories; D019804:Mesalamine