Role of triamcinolone in radiation enteritis management.
OBJECTIVE
To investigate the role of triamcinolone in the management of acute and chronic enteritis caused by pelvic radiotherapy.


METHODS
Twenty-eight patients with rectum adenocarcinoma or endometrium adenocarcinoma were studied. We compared the results of 14 patients treated with injected triamcinolone acetonide (TA) with those of 14 patients who were not treated with TA. For the TA group, 40 mg of TA was injected intramuscularly on the 1(st), 11(th) and 21(st) d of radiotherapy; the control group received no injections. All of the study participants had a median age of 65 years, had undergone postoperative radiotherapy and were evaluated weekly using Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer Acute Morbidity Score Criteria, and complete blood counts for every 10 d.


RESULTS
Triamcinolone was found to effectively prevent and treat radiation-induced acute gastrointestinal (enteritis) and genitourinary (cystitis) side effects (P = 0.022 and P = 0.023). For the lower GI side effect follow up, 11 patients in the control group had Grade 2 toxicity and 3 patients had Grade 1 toxicity. In the TA group, 5 patients had Grade 2 toxicity and 9 patients had Grade 1 toxicity. For the genitourinary system side effect follow up, 4 patients had Grade 2 toxicity and 6 patients had Grade 1 toxicity. Additionally, 2 patients had Grade 2 toxicity and 2 patients had Grade 1 toxicity. The neutrophil counts did not differ between the TA group and the control group. There was no meaningful difference between age groups and primary cancers. At the 12th mo of follow up, there were no differences between groups for chronic side effects.


CONCLUSIONS
Triamcinolone is a moderately potent steroid, that is inexpensive and has a good safety profile. It would be beneficial for reducing medical expenses related to treatment of radiation induced enteritis.
Eren Cetin, Sukran Ulger, Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara 06500, Turkey.
Eren
E
Cetin
Eren Cetin, Sukran Ulger, Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara 06500, Turkey.
Aysen Sevgi
AS
Ozturk
Eren Cetin, Sukran Ulger, Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara 06500, Turkey.
Haluk
H
Orhun
Eren Cetin, Sukran Ulger, Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara 06500, Turkey.
Sukran
S
Ulger
D000230:Adenocarcinoma / Q000150:complications / Q000532:radiotherapy; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D003556:Cystitis / Q000188:drug therapy / Q000209:etiology; D004751:Enteritis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011832:Radiation Injuries / Q000188:drug therapy*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012004:Rectal Neoplasms / Q000150:complications / Q000532:radiotherapy; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide
Cystitis; Enteritis; Radiotherapy; Triamcinolone