Treatment Of Chronic And Refractory Radiation Proctitis With Mesalazine Suppository. A Pilot Study

Purpose:To investigate the efficacy and safety of mesalazine suppository for chronic and refractory radiation proctitis.Methods:A prospective study was performed on a patient cohort with chronic and refractory radiation proctitis admitted to the First Affiliated Hospital of Guangxi Medical University between January 2010 and October 2014. All patients had colonoscopic and pathological diagnosis, met the inclusion criteria of chronic refractory radiation proctitis, and did not accept 5- aminosalicylates therapy 2 weeks before. A total of 10 patients with chronic and refractory radiation proctitis enrolled in the study. All patients were treated with mesalazine suppository (0.5g twice daily) for 24 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. Clinical and endoscopic follow-up was carried out.Results:A total of 10 patients with chronic and refractory radiation proctitis after radiotherapy of cervical cancer were enrolled in the study, an average of 48.8+8.41 years. At the treatment endpoin the symptoms score of bleeding(p=0.005), pain(p=0.005), stool frequency(p=0.004), tenesmus were obviously improved (p=0.004). The improvements of grading in endoscopy include telangiectasia(p=0.023), congested mucosa(p=0.008), ulceration(p=0.023) were all statistically significant. While the grades were not improved for stricture and necrosis(p=0.317,p=0.083). No side-effects were noted in any of the patients.Conclusions:Mesalazine suppository given by anal pluging may be a safe and effective treatment for chronic and refractory radiation proctitis.