title: Radiation enteritis leading to intestinal failure: 1994 patient-years of experience in a national referral centre.
abstract: OBJECTIVE
  Chronic radiation enteritis (RE) has been reported in up to 20% of patients receiving pelvic radiotherapy and can lead to intestinal failure (IF), accounting for 3.9% of new registrants for home parenteral nutrition (HPN) in the UK annually. Our aim is to report nutritional and survival outcomes for patients with RE referred to a national IF unit.
  
  
  METHODS
  A retrospective study of all new admissions over a 13-year period at the Intestinal Failure Centre, Manchester, UK. Data are presented as median (range).
  
  
  RESULTS
  Twenty-three (3.8%) of 611 patients were admitted with IF secondary to RE. The primary site of malignancy was genitourinary in 17 (74%) patients. Radiotherapy was administered 9.5 (1-42) years previously. Patients underwent 2 (1-5) laparotomies prior to intestinal failure unit (IFU) admission. Twelve (52%) patients were admitted with intestinal obstruction and 11 (48%) with intractable weight loss and/or high output fistulae/stomas. Additional conditions contributing to IF were noted in 11 (48%) patients. Twenty-two (96%) patients had 2 (1-5) laparotomies prior to IFU referral. At discharge, 5 (22%) patients resumed oral diet without the need for artificial nutrition support, 3 (13%) required enteral feeding and 13 (56%) commenced HPN. The 10-year survival of the patient cohort was 48.2%.
  
  
  CONCLUSIONS
  Surgical intervention is infrequently required, whereas the majority of patients with IF secondary to RE require long-term HPN. The judicious use of surgery in selected patients, coupled with an aggressive medical strategy to detect and treat contributing factors, and optimal enteral feeding may allow a modest proportion of patients with IF secondary to RE to achieve independence from PN.
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: R
authors: R
authors: Kalaiselvan
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: V S
authors: VS
authors: Theis
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: M
authors: M
authors: Dibb
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: A
authors: A
authors: Teubner
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: I D
authors: ID
authors: Anderson
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: J L
authors: JL
authors: Shaffer
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: G L
authors: GL
authors: Carlson
authors: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: S
authors: S
authors: Lal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004751:Enteritis / Q000209:etiology*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology* / Q000628:therapy*; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery / Q000628:therapy; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy; D016331:Parenteral Nutrition, Home; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000209:etiology / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome; D006113:United Kingdom; D014565:Urogenital Neoplasms / Q000532:radiotherapy