Terapêutica na Retite Actínica: revisão sistemática

Abstract

Malignant neoplasms are increasingly prevalent in daily clinical practice. Up to 61% of patients with pelvic malignancies receive pelvic radiotherapy in different doses. Pelvic radiotherapy may cause intestinal damage, being the rectum the segment most frequently affected by its fixed position in the pelvis. Currently, there are several strategies to minimize the effects of radiation on tissues surrounding the neoplastic site, despite those strategies, radiotherapy can still result in serious damage to organs and structures, and these injuries accompany patients throughout their lives. One of the most common damages resulting from pelvic radiotherapy is acute proctitis. The diagnosis is confirmed by visualizing the rectal mucosa through rigid or flexible rectosigmoidoscopy and colonoscopy. The objective of this study was to review the forms of radiation-induced proctopathy therapy, to evaluate the results of each method to propose a standardization for the treatment of this pathology. Despite the prevalence of radiation-induced proctopathy, there is no definitive standardized treatment strategy so far. First approach can be tried with local agents such as mesalazine and formalin. For refractory cases, control can be usually achieved with argon plasma coagulation, hyperbaric oxygen and radiofrequency ablation therapies. Regarding the study of radiation-induced proctopathy, there is a lack of robust with significant number of patients and standardized therapies to be compared. There is a lack of double blinded, randomized controlled studies that can determine a definitive standard treatment algorithm.