Skip to main content
Erschienen in: International Journal of Colorectal Disease 3/2006

01.04.2006 | Review

Late small bowel toxicity after adjuvant treatment for rectal cancer

verfasst von: Matthias Guckenberger, Michael Flentje

Erschienen in: International Journal of Colorectal Disease | Ausgabe 3/2006

Einloggen, um Zugang zu erhalten

Abstract

Background

For locally advanced rectal cancer surgery as sole treatment results in poor local control and survival. After adjuvant radiotherapy for locally advanced rectal cancer, small bowel toxicity has been the most frequent and serious side effect. The gain in survival and local control was accompanied by severe late chronic toxicity reducing the benefit of adjuvant treatment.

Review

Clinical factors, pathology and treatment of late small bowel toxicity after adjuvant radiotherapy for locally advanced rectal cancer will be discussed. This review will focus on different surgical and radiotherapeutic means reducing the risk of late small bowel damage.
Literatur
1.
Zurück zum Zitat American Cancer Society (2005) Cancer facts and figures. American Cancer Society, Atlanta American Cancer Society (2005) Cancer facts and figures. American Cancer Society, Atlanta
2.
Zurück zum Zitat Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland (2004) Krebs in Deutschland—Häufigkeiten und Trends, 4th edn. Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland, Saarbrücken Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland (2004) Krebs in Deutschland—Häufigkeiten und Trends, 4th edn. Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland, Saarbrücken
3.
Zurück zum Zitat Gastrointestinal Tumor Study Group (1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med 312:1465–1472 Gastrointestinal Tumor Study Group (1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med 312:1465–1472
4.
Zurück zum Zitat Swedish Rectal Cancer Trial (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987 Swedish Rectal Cancer Trial (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987
5.
Zurück zum Zitat Cox JD, Byhardt RW, Wilson JF, Haas JS, Komaki R, Olson LE (1986) Complications of radiation therapy and factors in their prevention. World J Surg 10:171–188CrossRefPubMed Cox JD, Byhardt RW, Wilson JF, Haas JS, Komaki R, Olson LE (1986) Complications of radiation therapy and factors in their prevention. World J Surg 10:171–188CrossRefPubMed
6.
Zurück zum Zitat Potish RA, Jones TK Jr, Levitt SH (1979) Factors predisposing to radiation-related small-bowel damage. Radiology 132:479–482PubMed Potish RA, Jones TK Jr, Levitt SH (1979) Factors predisposing to radiation-related small-bowel damage. Radiology 132:479–482PubMed
7.
Zurück zum Zitat Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, Langer C, Murphy B, Cumberlin R, Coleman CN, Rubin P (2003) CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol 13:176–181CrossRefPubMed Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, Langer C, Murphy B, Cumberlin R, Coleman CN, Rubin P (2003) CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol 13:176–181CrossRefPubMed
8.
Zurück zum Zitat Bourne RG, Kearsley JH, Grove WD, Roberts SJ (1983) The relationship between early and late gastrointestinal complications of radiation therapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 9:1445–1450PubMed Bourne RG, Kearsley JH, Grove WD, Roberts SJ (1983) The relationship between early and late gastrointestinal complications of radiation therapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 9:1445–1450PubMed
9.
Zurück zum Zitat Perez CA, Breaux S, Madoc-Jones H, Camel HM, Purdy J, Sharma S, Powers WE (1979) Correlation between radiation dose and tumor recurrence and complications in carcinoma of the uterine cervix: stages I and IIA. Int J Radiat Oncol Biol Phys 5:373–382PubMed Perez CA, Breaux S, Madoc-Jones H, Camel HM, Purdy J, Sharma S, Powers WE (1979) Correlation between radiation dose and tumor recurrence and complications in carcinoma of the uterine cervix: stages I and IIA. Int J Radiat Oncol Biol Phys 5:373–382PubMed
10.
Zurück zum Zitat Minsky BD, Cohen AM (1988) Minimizing the toxicity of pelvic radiation therapy in rectal cancer. Oncology (Huntingt) 2:21–25; 28–29 Minsky BD, Cohen AM (1988) Minimizing the toxicity of pelvic radiation therapy in rectal cancer. Oncology (Huntingt) 2:21–25; 28–29
11.
Zurück zum Zitat Piver MS, Barlow JJ (1977) High dose irradiation to biopsy confirmed aortic node metastases from carcinoma of the uterine cervix. Cancer 39:1243–1246PubMed Piver MS, Barlow JJ (1977) High dose irradiation to biopsy confirmed aortic node metastases from carcinoma of the uterine cervix. Cancer 39:1243–1246PubMed
12.
Zurück zum Zitat Wharton JT, Jones HW III, Day TG Jr, Rutledge FN, Fletcher GH (1977) Preirradiation celiotomy and extended field irradiation for invasive carcinoma of the cervix. Obstet Gynecol 49:333–338PubMed Wharton JT, Jones HW III, Day TG Jr, Rutledge FN, Fletcher GH (1977) Preirradiation celiotomy and extended field irradiation for invasive carcinoma of the cervix. Obstet Gynecol 49:333–338PubMed
13.
Zurück zum Zitat Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF, Karstens JH, Liersch T, Schmidberger H, Raab R (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351:1731–1740CrossRefPubMed Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF, Karstens JH, Liersch T, Schmidberger H, Raab R (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351:1731–1740CrossRefPubMed
14.
Zurück zum Zitat Frykholm GJ, Glimelius B, Pahlman L (1993) Preoperative or postoperative irradiation in adenocarcinoma of the rectum: final treatment results of a randomized trial and an evaluation of late secondary effects. Dis Colon Rectum 36:564–572PubMed Frykholm GJ, Glimelius B, Pahlman L (1993) Preoperative or postoperative irradiation in adenocarcinoma of the rectum: final treatment results of a randomized trial and an evaluation of late secondary effects. Dis Colon Rectum 36:564–572PubMed
15.
Zurück zum Zitat Mak AC, Rich TA, Schultheiss TE, Kavanagh B, Ota DM, Romsdahl MM (1994) Late complications of postoperative radiation therapy for cancer of the rectum and rectosigmoid. Int J Radiat Oncol Biol Phys 28:597–603PubMed Mak AC, Rich TA, Schultheiss TE, Kavanagh B, Ota DM, Romsdahl MM (1994) Late complications of postoperative radiation therapy for cancer of the rectum and rectosigmoid. Int J Radiat Oncol Biol Phys 28:597–603PubMed
16.
Zurück zum Zitat Gallagher MJ, Brereton HD, Rostock RA, Zero JM, Zekoski DA, Poyss LF, Richter MP, Kligerman MM (1986) A prospective study of treatment techniques to minimize the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation. Int J Radiat Oncol Biol Phys 12:1565–1573PubMed Gallagher MJ, Brereton HD, Rostock RA, Zero JM, Zekoski DA, Poyss LF, Richter MP, Kligerman MM (1986) A prospective study of treatment techniques to minimize the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation. Int J Radiat Oncol Biol Phys 12:1565–1573PubMed
17.
Zurück zum Zitat Letschert JG, Lebesque JV, Aleman BM, Bosset JF, Horiot JC, Bartelink H, Cionini L, Hamers JP, Leer JW, van Glabbeke M (1994) The volume effect in radiation-related late small bowel complications: results of a clinical study of the EORTC Radiotherapy Cooperative Group in patients treated for rectal carcinoma. Radiother Oncol 32:116–123CrossRefPubMed Letschert JG, Lebesque JV, Aleman BM, Bosset JF, Horiot JC, Bartelink H, Cionini L, Hamers JP, Leer JW, van Glabbeke M (1994) The volume effect in radiation-related late small bowel complications: results of a clinical study of the EORTC Radiotherapy Cooperative Group in patients treated for rectal carcinoma. Radiother Oncol 32:116–123CrossRefPubMed
18.
Zurück zum Zitat Gabbiani G (2003) The myofibroblast in wound healing and fibrocontractive diseases. J Pathol 200:500–503CrossRefPubMed Gabbiani G (2003) The myofibroblast in wound healing and fibrocontractive diseases. J Pathol 200:500–503CrossRefPubMed
19.
Zurück zum Zitat Rubin P, Johnston CJ, Williams JP, McDonald S, Finkelstein JN (1995) A perpetual cascade of cytokines postirradiation leads to pulmonary fibrosis. Int J Radiat Oncol Biol Phys 33:99–109CrossRefPubMed Rubin P, Johnston CJ, Williams JP, McDonald S, Finkelstein JN (1995) A perpetual cascade of cytokines postirradiation leads to pulmonary fibrosis. Int J Radiat Oncol Biol Phys 33:99–109CrossRefPubMed
20.
Zurück zum Zitat Leask A, Abraham DJ (2004) TGF-beta signaling and the fibrotic response. FASEB J 18:816–827CrossRefPubMed Leask A, Abraham DJ (2004) TGF-beta signaling and the fibrotic response. FASEB J 18:816–827CrossRefPubMed
21.
Zurück zum Zitat Vozenin-Brotons MC, Milliat F, Linard C, Strup C, Francois A, Sabourin JC, Lasser P, Lusinchi A, Deutsch E, Girinsky T, Aigueperse J, Bourhis J, Mathe D (2004) Gene expression profile in human late radiation enteritis obtained by high-density cDNA array hybridization. Radiat Res 161:299–311PubMed Vozenin-Brotons MC, Milliat F, Linard C, Strup C, Francois A, Sabourin JC, Lasser P, Lusinchi A, Deutsch E, Girinsky T, Aigueperse J, Bourhis J, Mathe D (2004) Gene expression profile in human late radiation enteritis obtained by high-density cDNA array hybridization. Radiat Res 161:299–311PubMed
22.
Zurück zum Zitat Withers HR, Romsdahl MM (1977) Post-operative radiotherapy for adenocarcinoma of the rectum and rectosigmoid. Int J Radiat Oncol Biol Phys 2:1069–1074PubMed Withers HR, Romsdahl MM (1977) Post-operative radiotherapy for adenocarcinoma of the rectum and rectosigmoid. Int J Radiat Oncol Biol Phys 2:1069–1074PubMed
23.
Zurück zum Zitat Stockholm Rectal Cancer Study Group (1990) Preoperative short-term radiation therapy in operable rectal carcinoma. A prospective randomized trial. Cancer 66:49–55 Stockholm Rectal Cancer Study Group (1990) Preoperative short-term radiation therapy in operable rectal carcinoma. A prospective randomized trial. Cancer 66:49–55
24.
Zurück zum Zitat Frykholm GJ, Isacsson U, Nygard K, Montelius A, Jung B, Pahlman L, Glimelius B (1996) Preoperative radiotherapy in rectal carcinoma—aspects of acute adverse effects and radiation technique. Int J Radiat Oncol Biol Phys 35:1039–1048CrossRefPubMed Frykholm GJ, Isacsson U, Nygard K, Montelius A, Jung B, Pahlman L, Glimelius B (1996) Preoperative radiotherapy in rectal carcinoma—aspects of acute adverse effects and radiation technique. Int J Radiat Oncol Biol Phys 35:1039–1048CrossRefPubMed
25.
Zurück zum Zitat Myerson RJ (2003) Colon and rectum. In: Perez CA et al (eds) Principles and practice of radiation oncology. Lippincott Williams and Wilkins, Philadelphia Myerson RJ (2003) Colon and rectum. In: Perez CA et al (eds) Principles and practice of radiation oncology. Lippincott Williams and Wilkins, Philadelphia
26.
Zurück zum Zitat Kolbl O, Richter S, Flentje M (2000) Influence of treatment technique on dose-volume histogram and normal tissue complication probability for small bowel and bladder. A prospective study using a 3-D planning system and a radiobiological model in patients receiving postoperative pelvic irradiation. Strahlenther Onkol 176:105–111PubMed Kolbl O, Richter S, Flentje M (2000) Influence of treatment technique on dose-volume histogram and normal tissue complication probability for small bowel and bladder. A prospective study using a 3-D planning system and a radiobiological model in patients receiving postoperative pelvic irradiation. Strahlenther Onkol 176:105–111PubMed
27.
Zurück zum Zitat Galland RB, Spencer J (1986) Surgical management of radiation enteritis. Surgery 99:133–139PubMed Galland RB, Spencer J (1986) Surgical management of radiation enteritis. Surgery 99:133–139PubMed
28.
Zurück zum Zitat Shanahan TG, Mehta MP, Bertelrud KL, Buchler DA, Frank LE, Gehring MA, Kubsad SS, Utrie PC, Kinsella TJ (1990) Minimization of small bowel volume within treatment fields utilizing customized “belly boards”. Int J Radiat Oncol Biol Phys 19:469–476PubMed Shanahan TG, Mehta MP, Bertelrud KL, Buchler DA, Frank LE, Gehring MA, Kubsad SS, Utrie PC, Kinsella TJ (1990) Minimization of small bowel volume within treatment fields utilizing customized “belly boards”. Int J Radiat Oncol Biol Phys 19:469–476PubMed
29.
Zurück zum Zitat Fu YT, Lam JC, Tze JM (1995) Measurement of irradiated small bowel volume in pelvic irradiation and the effect of a bellyboard. Clin Oncol ® Coll Radiol) 7:188–192 Fu YT, Lam JC, Tze JM (1995) Measurement of irradiated small bowel volume in pelvic irradiation and the effect of a bellyboard. Clin Oncol ® Coll Radiol) 7:188–192
30.
Zurück zum Zitat Koelbl O, Richter S, Flentje M (1999) Influence of patient positioning on dose-volume histogram and normal tissue complication probability for small bowel and bladder in patients receiving pelvic irradiation: a prospective study using a 3D planning system and a radiobiological model. Int J Radiat Oncol Biol Phys 45:1193–1198CrossRefPubMed Koelbl O, Richter S, Flentje M (1999) Influence of patient positioning on dose-volume histogram and normal tissue complication probability for small bowel and bladder in patients receiving pelvic irradiation: a prospective study using a 3D planning system and a radiobiological model. Int J Radiat Oncol Biol Phys 45:1193–1198CrossRefPubMed
31.
Zurück zum Zitat Koelbl O, Vordermark D, Flentje M (2003) The relationship between belly board position and patient anatomy and its influence on dose-volume histogram of small bowel for postoperative radiotherapy of rectal cancer. Radiother Oncol 67:345–349CrossRefPubMed Koelbl O, Vordermark D, Flentje M (2003) The relationship between belly board position and patient anatomy and its influence on dose-volume histogram of small bowel for postoperative radiotherapy of rectal cancer. Radiother Oncol 67:345–349CrossRefPubMed
32.
Zurück zum Zitat Rudat V, Flentje M, Engenhart R, Metzger M, Wannenmacher M (1995) The belly-board technic for the sparing of the small intestine. Studies on positioning accuracy taking into consideration conformational irradiation technics. Strahlenther Onkol 171:437–443PubMed Rudat V, Flentje M, Engenhart R, Metzger M, Wannenmacher M (1995) The belly-board technic for the sparing of the small intestine. Studies on positioning accuracy taking into consideration conformational irradiation technics. Strahlenther Onkol 171:437–443PubMed
33.
Zurück zum Zitat Das IJ, Lanciano RM, Movsas B, Kagawa K, Barnes SJ (1997) Efficacy of a belly board device with CT-simulation in reducing small bowel volume within pelvic irradiation fields. Int J Radiat Oncol Biol Phys 39:67–76CrossRefPubMed Das IJ, Lanciano RM, Movsas B, Kagawa K, Barnes SJ (1997) Efficacy of a belly board device with CT-simulation in reducing small bowel volume within pelvic irradiation fields. Int J Radiat Oncol Biol Phys 39:67–76CrossRefPubMed
34.
Zurück zum Zitat Allal AS, Bischof S, Nouet P (2002) Impact of the “belly board” device on treatment reproducibility in preoperative radiotherapy for rectal cancer. Strahlenther Onkol 178:259–262CrossRefPubMed Allal AS, Bischof S, Nouet P (2002) Impact of the “belly board” device on treatment reproducibility in preoperative radiotherapy for rectal cancer. Strahlenther Onkol 178:259–262CrossRefPubMed
35.
Zurück zum Zitat Nuyttens JJ, Robertson JM, Yan D, Martinez A (2001) The position and volume of the small bowel during adjuvant radiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys 51:1271–1280CrossRefPubMed Nuyttens JJ, Robertson JM, Yan D, Martinez A (2001) The position and volume of the small bowel during adjuvant radiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys 51:1271–1280CrossRefPubMed
36.
Zurück zum Zitat Miller AR, Martenson JA, Nelson H, Schleck CD, Ilstrup DM, Gunderson LL, Donohue JH (1999) The incidence and clinical consequences of treatment-related bowel injury. Int J Radiat Oncol Biol Phys 43:817–825CrossRefPubMed Miller AR, Martenson JA, Nelson H, Schleck CD, Ilstrup DM, Gunderson LL, Donohue JH (1999) The incidence and clinical consequences of treatment-related bowel injury. Int J Radiat Oncol Biol Phys 43:817–825CrossRefPubMed
37.
Zurück zum Zitat LoIudice T, Baxter D, Balint J (1977) Effects of abdominal surgery on the development of radiation enteropathy. Gastroenterology 73:1093–1097PubMed LoIudice T, Baxter D, Balint J (1977) Effects of abdominal surgery on the development of radiation enteropathy. Gastroenterology 73:1093–1097PubMed
38.
Zurück zum Zitat Sher ME, Bauer J (1990) Radiation-induced enteropathy. Am J Gastroenterol 85:121–128PubMed Sher ME, Bauer J (1990) Radiation-induced enteropathy. Am J Gastroenterol 85:121–128PubMed
39.
Zurück zum Zitat Coia LR, Myerson RJ, Tepper JE (1995) Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys 31:1213–1236CrossRefPubMed Coia LR, Myerson RJ, Tepper JE (1995) Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys 31:1213–1236CrossRefPubMed
40.
Zurück zum Zitat Sugarbaker PH (1983) Intrapelvic prosthesis to prevent injury of the small intestine with high dosage pelvic irradiation. Surg Gynecol Obstet 157:269–271PubMed Sugarbaker PH (1983) Intrapelvic prosthesis to prevent injury of the small intestine with high dosage pelvic irradiation. Surg Gynecol Obstet 157:269–271PubMed
41.
Zurück zum Zitat Durig M, Steenblock U, Heberer M, Harder F (1984) Prevention of radiation injuries to the small intestine. Surg Gynecol Obstet 159:162–163PubMed Durig M, Steenblock U, Heberer M, Harder F (1984) Prevention of radiation injuries to the small intestine. Surg Gynecol Obstet 159:162–163PubMed
42.
Zurück zum Zitat Feldman MI, Kavanah MT, Devereux DF, Choe S (1988) New surgical method to prevent pelvic radiation enteropathy. Am J Clin Oncol 11:25–33PubMed Feldman MI, Kavanah MT, Devereux DF, Choe S (1988) New surgical method to prevent pelvic radiation enteropathy. Am J Clin Oncol 11:25–33PubMed
43.
Zurück zum Zitat Devereux DF, Chandler JJ, Eisenstat T, Zinkin L (1988) Efficacy of an absorbable mesh in keeping the small bowel out of the human pelvis following surgery. Dis Colon Rectum 31:17–21PubMed Devereux DF, Chandler JJ, Eisenstat T, Zinkin L (1988) Efficacy of an absorbable mesh in keeping the small bowel out of the human pelvis following surgery. Dis Colon Rectum 31:17–21PubMed
44.
Zurück zum Zitat Russ JE, Smoron GL, Gagnon JD (1984) Omental transposition flap in colorectal carcinoma: adjunctive use in prevention and treatment of radiation complications. Int J Radiat Oncol Biol Phys 10:55–62 Russ JE, Smoron GL, Gagnon JD (1984) Omental transposition flap in colorectal carcinoma: adjunctive use in prevention and treatment of radiation complications. Int J Radiat Oncol Biol Phys 10:55–62
45.
Zurück zum Zitat DeLuca FR, Ragins H (1985) Construction of an omental envelope as a method of excluding the small intestine from the field of postoperative irradiation to the pelvis. Surg Gynecol Obstet 160:365–366PubMed DeLuca FR, Ragins H (1985) Construction of an omental envelope as a method of excluding the small intestine from the field of postoperative irradiation to the pelvis. Surg Gynecol Obstet 160:365–366PubMed
46.
Zurück zum Zitat Waddell BE, Rodriguez-Bigas MA, Lee RJ, Weber TK, Petrelli NJ (1999) Prevention of chronic radiation enteritis. J Am Coll Surg 189:611–624CrossRefPubMed Waddell BE, Rodriguez-Bigas MA, Lee RJ, Weber TK, Petrelli NJ (1999) Prevention of chronic radiation enteritis. J Am Coll Surg 189:611–624CrossRefPubMed
47.
Zurück zum Zitat Thom A, Baumann J, Chandler JJ, Devereux DF (1992) Experience with high-dose radiation therapy and the intestinal sling procedure in patients with rectal carcinoma. Cancer 70:581–584PubMed Thom A, Baumann J, Chandler JJ, Devereux DF (1992) Experience with high-dose radiation therapy and the intestinal sling procedure in patients with rectal carcinoma. Cancer 70:581–584PubMed
48.
Zurück zum Zitat Waddell BE, Lee RJ, Rodriguez-Bigas MA, Weber TK, Petrelli NJ (2000) Absorbable mesh sling prevents radiation-induced bowel injury during “sandwich” chemoradiation for rectal cancer. Arch Surg 135:1212–1217CrossRefPubMed Waddell BE, Lee RJ, Rodriguez-Bigas MA, Weber TK, Petrelli NJ (2000) Absorbable mesh sling prevents radiation-induced bowel injury during “sandwich” chemoradiation for rectal cancer. Arch Surg 135:1212–1217CrossRefPubMed
49.
Zurück zum Zitat Rodier JF, Janser JC, Rodier D, Dauplat J, Kauffmann P, Le Bouedec G, Giraud B, Lorimier G (1991) Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling. A 60-case multicentric study. Cancer 68:2545–2549PubMed Rodier JF, Janser JC, Rodier D, Dauplat J, Kauffmann P, Le Bouedec G, Giraud B, Lorimier G (1991) Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling. A 60-case multicentric study. Cancer 68:2545–2549PubMed
50.
Zurück zum Zitat Beitler A, Rodriguez-Bigas MA, Weber TK, Lee RJ, Cuenca R, Petrelli NJ (1997) Complications of absorbable pelvic mesh slings following surgery for rectal carcinoma. Dis Colon Rectum 40:1336–1341PubMed Beitler A, Rodriguez-Bigas MA, Weber TK, Lee RJ, Cuenca R, Petrelli NJ (1997) Complications of absorbable pelvic mesh slings following surgery for rectal carcinoma. Dis Colon Rectum 40:1336–1341PubMed
51.
Zurück zum Zitat Sloan DA (1994) Complete small bowel obstruction in the early postoperative period complicating surgical sling procedure. Am Surg 60:282–286PubMed Sloan DA (1994) Complete small bowel obstruction in the early postoperative period complicating surgical sling procedure. Am Surg 60:282–286PubMed
52.
Zurück zum Zitat Herbert SH, Solin LJ, Hoffman JP, Schultz DJ, Curran WJ, Jr, Lanciano RM, Rosenblum N, Hogan M, Eisenberg B, Hanks GE (1993) Volumetric analysis of small bowel displacement from radiation portals with the use of a pelvic tissue expander. Int J Radiat Oncol Biol Phys 25:885–893PubMed Herbert SH, Solin LJ, Hoffman JP, Schultz DJ, Curran WJ, Jr, Lanciano RM, Rosenblum N, Hogan M, Eisenberg B, Hanks GE (1993) Volumetric analysis of small bowel displacement from radiation portals with the use of a pelvic tissue expander. Int J Radiat Oncol Biol Phys 25:885–893PubMed
53.
Zurück zum Zitat Hoffman JP, Lanciano R, Carp NZ, Merrick MA, Rosenblum NG, Hogan WM, Sigurdson ER, Litwin S, Eisenberg BL (1994) Morbidity after intraperitoneal insertion of saline-filled tissue expanders for small bowel exclusion from radiotherapy treatment fields: a prospective four year experience with 34 patients. Am Surg 60:473–482; discussion 482–473PubMed Hoffman JP, Lanciano R, Carp NZ, Merrick MA, Rosenblum NG, Hogan WM, Sigurdson ER, Litwin S, Eisenberg BL (1994) Morbidity after intraperitoneal insertion of saline-filled tissue expanders for small bowel exclusion from radiotherapy treatment fields: a prospective four year experience with 34 patients. Am Surg 60:473–482; discussion 482–473PubMed
54.
Zurück zum Zitat Hoffman JP, Sigurdson ER, Eisenberg BL (1998) Use of saline-filled tissue expanders to protect the small bowel from radiation. Oncology (Huntingt) 12:51–54 discussion 54, 60, 62, passim Hoffman JP, Sigurdson ER, Eisenberg BL (1998) Use of saline-filled tissue expanders to protect the small bowel from radiation. Oncology (Huntingt) 12:51–54 discussion 54, 60, 62, passim
55.
Zurück zum Zitat Potish RA (1982) Importance of predisposing factors in the development of enteric damage. Am J Clin Oncol 5:189–194PubMed Potish RA (1982) Importance of predisposing factors in the development of enteric damage. Am J Clin Oncol 5:189–194PubMed
56.
Zurück zum Zitat Maruyama Y, Van Nagell JR Jr, Utley J, Vider ML, Parker JC (1974) Radiation and small bowel complications in cervical carcinoma therapy. Radiology 112:699–703PubMed Maruyama Y, Van Nagell JR Jr, Utley J, Vider ML, Parker JC (1974) Radiation and small bowel complications in cervical carcinoma therapy. Radiology 112:699–703PubMed
57.
Zurück zum Zitat Potish RA (1977) The effect of pelvic inflammatory disease on enteric damage. Am J Clin Oncol 5:767–771 Potish RA (1977) The effect of pelvic inflammatory disease on enteric damage. Am J Clin Oncol 5:767–771
58.
Zurück zum Zitat Van Nagell JR Jr, Parker JC Jr, Maruyama Y, Utley J, Hager WD, Donaldson ES, Wood EG (1977) The effect of pelvic inflammatory disease on enteric complications following radiation therapy for cervical cancer. Am J Obstet Gynecol 128:767–771PubMed Van Nagell JR Jr, Parker JC Jr, Maruyama Y, Utley J, Hager WD, Donaldson ES, Wood EG (1977) The effect of pelvic inflammatory disease on enteric complications following radiation therapy for cervical cancer. Am J Obstet Gynecol 128:767–771PubMed
59.
Zurück zum Zitat Green S, Stock RG, Greenstein AJ (1999) Rectal cancer and inflammatory bowel disease: natural history and implications for radiation therapy. Int J Radiat Oncol Biol Phys 44:835–840CrossRefPubMed Green S, Stock RG, Greenstein AJ (1999) Rectal cancer and inflammatory bowel disease: natural history and implications for radiation therapy. Int J Radiat Oncol Biol Phys 44:835–840CrossRefPubMed
60.
Zurück zum Zitat Willett CG, Ooi CJ, Zietman AL, Menon V, Goldberg S, Sands BE, Podolsky DK (2000) Acute and late toxicity of patients with inflammatory bowel disease undergoing irradiation for abdominal and pelvic neoplasms. Int J Radiat Oncol Biol Phys 46:995–998CrossRefPubMed Willett CG, Ooi CJ, Zietman AL, Menon V, Goldberg S, Sands BE, Podolsky DK (2000) Acute and late toxicity of patients with inflammatory bowel disease undergoing irradiation for abdominal and pelvic neoplasms. Int J Radiat Oncol Biol Phys 46:995–998CrossRefPubMed
61.
Zurück zum Zitat Song DY, Lawrie WT, Abrams RA, Kafonek DR, Bayless TM, Welsh JS, DeWeese TL (2001) Acute and late radiotherapy toxicity in patients with inflammatory bowel disease. Int J Radiat Oncol Biol Phys 51:455–459CrossRefPubMed Song DY, Lawrie WT, Abrams RA, Kafonek DR, Bayless TM, Welsh JS, DeWeese TL (2001) Acute and late radiotherapy toxicity in patients with inflammatory bowel disease. Int J Radiat Oncol Biol Phys 51:455–459CrossRefPubMed
62.
Zurück zum Zitat Martling A, Holm T, Johansson H, Rutqvist LE, Cedermark B (2001) The Stockholm II trial on preoperative radiotherapy in rectal carcinoma: long-term follow-up of a population-based study. Cancer 92:896–902CrossRefPubMed Martling A, Holm T, Johansson H, Rutqvist LE, Cedermark B (2001) The Stockholm II trial on preoperative radiotherapy in rectal carcinoma: long-term follow-up of a population-based study. Cancer 92:896–902CrossRefPubMed
63.
Zurück zum Zitat Pahlman L, Glimelius B (1990) Pre- or postoperative radiotherapy in rectal and rectosigmoid carcinoma. Report from a randomized multicenter trial. Ann Surg 211:187–195PubMed Pahlman L, Glimelius B (1990) Pre- or postoperative radiotherapy in rectal and rectosigmoid carcinoma. Report from a randomized multicenter trial. Ann Surg 211:187–195PubMed
64.
Zurück zum Zitat Holm T, Singnomklao T, Rutqvist LE, Cedermark B (1996) Adjuvant preoperative radiotherapy in patients with rectal carcinoma. Adverse effects during long term follow-up of two randomized trials. Cancer 78:968–976PubMed Holm T, Singnomklao T, Rutqvist LE, Cedermark B (1996) Adjuvant preoperative radiotherapy in patients with rectal carcinoma. Adverse effects during long term follow-up of two randomized trials. Cancer 78:968–976PubMed
65.
Zurück zum Zitat Glimelius B, Isacsson U (2001) Preoperative radiotherapy for rectal cancer—is 5×5 Gy a good or a bad schedule? Acta Oncol 40:958–967CrossRefPubMed Glimelius B, Isacsson U (2001) Preoperative radiotherapy for rectal cancer—is 5×5 Gy a good or a bad schedule? Acta Oncol 40:958–967CrossRefPubMed
66.
Zurück zum Zitat Dahlberg M, Glimelius B, Graf W, Pahlman L (1998) Preoperative irradiation affects functional results after surgery for rectal cancer: results from a randomized study. Dis Colon Rectum 41:543–549; discussion 549–551PubMed Dahlberg M, Glimelius B, Graf W, Pahlman L (1998) Preoperative irradiation affects functional results after surgery for rectal cancer: results from a randomized study. Dis Colon Rectum 41:543–549; discussion 549–551PubMed
67.
Zurück zum Zitat Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW, van de Velde CJ (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646CrossRefPubMed Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW, van de Velde CJ (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646CrossRefPubMed
68.
Zurück zum Zitat King M, Tolan S, Giridharan S, McConkey C, Hartley A, Geh JI (2003) Late toxicity after short course preoperative radiotherapy and total mesorectal excision for resectable rectal cancer. Clin Oncol ® Coll Radiol) 15:233–236 King M, Tolan S, Giridharan S, McConkey C, Hartley A, Geh JI (2003) Late toxicity after short course preoperative radiotherapy and total mesorectal excision for resectable rectal cancer. Clin Oncol ® Coll Radiol) 15:233–236
69.
Zurück zum Zitat Glimelius B, Pahlman L (1999) Perioperative radiotherapy in rectal cancer. Acta Oncol 38:23–32PubMed Glimelius B, Pahlman L (1999) Perioperative radiotherapy in rectal cancer. Acta Oncol 38:23–32PubMed
70.
Zurück zum Zitat Krook JE, Moertel CG, Gunderson LL, Wieand HS, Collins RT, Beart RW, Kubista TP, Poon MA, Meyers WC, Mailliard JA et al (1991) Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324:709–715PubMed Krook JE, Moertel CG, Gunderson LL, Wieand HS, Collins RT, Beart RW, Kubista TP, Poon MA, Meyers WC, Mailliard JA et al (1991) Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324:709–715PubMed
71.
Zurück zum Zitat Minsky BD, Conti JA, Huang Y, Knopf K (1995) Relationship of acute gastrointestinal toxicity and the volume of irradiated small bowel in patients receiving combined modality therapy for rectal cancer. J Clin Oncol 13:1409–1416PubMed Minsky BD, Conti JA, Huang Y, Knopf K (1995) Relationship of acute gastrointestinal toxicity and the volume of irradiated small bowel in patients receiving combined modality therapy for rectal cancer. J Clin Oncol 13:1409–1416PubMed
72.
Zurück zum Zitat O’Connell MJ, Martenson JA, Wieand HS, Krook JE, Macdonald JS, Haller DG, Mayer RJ, Gunderson LL, Rich TA (1994) Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 331:502–507CrossRefPubMed O’Connell MJ, Martenson JA, Wieand HS, Krook JE, Macdonald JS, Haller DG, Mayer RJ, Gunderson LL, Rich TA (1994) Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 331:502–507CrossRefPubMed
73.
Zurück zum Zitat Wulf J, Kramer K, van Aaken C, Dietzel F, Lucas D, Pfandner K, Schimpke T, Schulze W, Thiel HJ, Ziegler K, Flentje M (2004) Outcome of postoperative treatment for rectal cancer UICC stage II and III in day-to-day clinical practice. Results from a retrospective quality control analysis in six institutions in North Bavaria (Germany). Strahlenther Onkol 180:5–14CrossRefPubMed Wulf J, Kramer K, van Aaken C, Dietzel F, Lucas D, Pfandner K, Schimpke T, Schulze W, Thiel HJ, Ziegler K, Flentje M (2004) Outcome of postoperative treatment for rectal cancer UICC stage II and III in day-to-day clinical practice. Results from a retrospective quality control analysis in six institutions in North Bavaria (Germany). Strahlenther Onkol 180:5–14CrossRefPubMed
74.
Zurück zum Zitat Rodel C, Grabenbauer GG, Schick C, Papadopoulos T, Hohenberger W, Sauer R (2000) Preoperative radiation with concurrent 5-fluorouracil for locally advanced T4-primary rectal cancer. Strahlenther Onkol 176:161–167CrossRefPubMed Rodel C, Grabenbauer GG, Schick C, Papadopoulos T, Hohenberger W, Sauer R (2000) Preoperative radiation with concurrent 5-fluorouracil for locally advanced T4-primary rectal cancer. Strahlenther Onkol 176:161–167CrossRefPubMed
75.
Zurück zum Zitat Videtic GM, Fisher BJ, Perera FE, Bauman GS, Kocha WI, Taylor M, Vincent MD, Plewes EA, Engel CJ, Stitt LW (1998) Preoperative radiation with concurrent 5-fluorouracil continuous infusion for locally advanced unresectable rectal cancer. Int J Radiat Oncol Biol Phys 42:319–324CrossRefPubMed Videtic GM, Fisher BJ, Perera FE, Bauman GS, Kocha WI, Taylor M, Vincent MD, Plewes EA, Engel CJ, Stitt LW (1998) Preoperative radiation with concurrent 5-fluorouracil continuous infusion for locally advanced unresectable rectal cancer. Int J Radiat Oncol Biol Phys 42:319–324CrossRefPubMed
76.
Zurück zum Zitat Wagman R, Minsky BD, Cohen AM, Guillem JG, Paty PP (1998) Sphincter preservation in rectal cancer with preoperative radiation therapy and coloanal anastomosis: long term follow-up. Int J Radiat Oncol Biol Phys 42:51–57CrossRefPubMed Wagman R, Minsky BD, Cohen AM, Guillem JG, Paty PP (1998) Sphincter preservation in rectal cancer with preoperative radiation therapy and coloanal anastomosis: long term follow-up. Int J Radiat Oncol Biol Phys 42:51–57CrossRefPubMed
77.
Zurück zum Zitat Tuchmann L, Engelking C (2001) Cancer-related diarrhea. In: Gates RA, Fink RM (eds) Oncology nursing secrets. Hanley and Belfus, Philadelphia, pp 310–322 Tuchmann L, Engelking C (2001) Cancer-related diarrhea. In: Gates RA, Fink RM (eds) Oncology nursing secrets. Hanley and Belfus, Philadelphia, pp 310–322
78.
Zurück zum Zitat National Cancer Institute (2003) Radiation enteritis (PDQ) in supportive care National Cancer Institute (2003) Radiation enteritis (PDQ) in supportive care
79.
Zurück zum Zitat Chary S, Thomson DH (1984) A clinical trial evaluating cholestyramine to prevent diarrhea in patients maintained on low-fat diets during pelvic radiation therapy. Int J Radiat Oncol Biol Phys 10:1885–1890PubMed Chary S, Thomson DH (1984) A clinical trial evaluating cholestyramine to prevent diarrhea in patients maintained on low-fat diets during pelvic radiation therapy. Int J Radiat Oncol Biol Phys 10:1885–1890PubMed
80.
Zurück zum Zitat Verhaeghe M, Laurent JC, Dupont A, Madelain M, Rohart J (1981) [Surgical treatment of intestinal radio-lesions. 53 patients operated, out of 171 radio-lesions among 7301 irradiated] (author’s transl). J Chir (Paris) 118:221–229 Verhaeghe M, Laurent JC, Dupont A, Madelain M, Rohart J (1981) [Surgical treatment of intestinal radio-lesions. 53 patients operated, out of 171 radio-lesions among 7301 irradiated] (author’s transl). J Chir (Paris) 118:221–229
81.
Zurück zum Zitat Schmitt EH III, Symmonds RE (1981) Surgical treatment of radiation induced injuries of the intestine. Surg Gynecol Obstet 153:896–900PubMed Schmitt EH III, Symmonds RE (1981) Surgical treatment of radiation induced injuries of the intestine. Surg Gynecol Obstet 153:896–900PubMed
82.
Zurück zum Zitat Wellwood JM, Jackson BT (1973) The intestinal complications of radiotherapy. Br J Surg 60:814–818PubMed Wellwood JM, Jackson BT (1973) The intestinal complications of radiotherapy. Br J Surg 60:814–818PubMed
83.
Zurück zum Zitat Regimbeau JM, Panis Y, Gouzi JL, Fagniez PL (2001) Operative and long term results after surgery for chronic radiation enteritis. Am J Surg 182:237–242CrossRefPubMed Regimbeau JM, Panis Y, Gouzi JL, Fagniez PL (2001) Operative and long term results after surgery for chronic radiation enteritis. Am J Surg 182:237–242CrossRefPubMed
84.
Zurück zum Zitat Wobbes T, Verschueren RC, Lubbers EJ, Jansen W, Paping RH (1984) Surgical aspects of radiation enteritis of the small bowel. Dis Colon Rectum 27:89–92PubMed Wobbes T, Verschueren RC, Lubbers EJ, Jansen W, Paping RH (1984) Surgical aspects of radiation enteritis of the small bowel. Dis Colon Rectum 27:89–92PubMed
85.
Zurück zum Zitat Cross MJ, Frazee RC (1992) Surgical treatment of radiation enteritis. Am Surg 58:132–135PubMed Cross MJ, Frazee RC (1992) Surgical treatment of radiation enteritis. Am Surg 58:132–135PubMed
86.
Zurück zum Zitat Jahnson S, Westerborn O, Gerdin B (1992) Prognosis of surgically treated radiation-induced damage to the intestine. Eur J Surg Oncol 18:487–493PubMed Jahnson S, Westerborn O, Gerdin B (1992) Prognosis of surgically treated radiation-induced damage to the intestine. Eur J Surg Oncol 18:487–493PubMed
87.
Zurück zum Zitat Dietz DW, Remzi FH, Fazio VW (2001) Strictureplasty for obstructing small-bowel lesions in diffuse radiation enteritis—successful outcome in five patients. Dis Colon Rectum 44:1772–1777PubMed Dietz DW, Remzi FH, Fazio VW (2001) Strictureplasty for obstructing small-bowel lesions in diffuse radiation enteritis—successful outcome in five patients. Dis Colon Rectum 44:1772–1777PubMed
88.
Zurück zum Zitat Gastrointestinal Tumor Study Group (1992) Radiation therapy and fluorouracil with or without semustine for the treatment of patients with surgical adjuvant adenocarcinoma of the rectum. J Clin Oncol 10:549–557 Gastrointestinal Tumor Study Group (1992) Radiation therapy and fluorouracil with or without semustine for the treatment of patients with surgical adjuvant adenocarcinoma of the rectum. J Clin Oncol 10:549–557
89.
Zurück zum Zitat Tveit KM, Guldvog I, Hagen S, Trondsen E, Harbitz T, Nygaard K, Nilsen JB, Wist E, Hannisdal E (1997) Randomized controlled trial of postoperative radiotherapy and short-term time-scheduled 5-fluorouracil against surgery alone in the treatment of Dukes B and C rectal cancer. Norwegian Adjuvant Rectal Cancer Project Group. Br J Surg 84:1130–1135CrossRefPubMed Tveit KM, Guldvog I, Hagen S, Trondsen E, Harbitz T, Nygaard K, Nilsen JB, Wist E, Hannisdal E (1997) Randomized controlled trial of postoperative radiotherapy and short-term time-scheduled 5-fluorouracil against surgery alone in the treatment of Dukes B and C rectal cancer. Norwegian Adjuvant Rectal Cancer Project Group. Br J Surg 84:1130–1135CrossRefPubMed
Metadaten
Titel
Late small bowel toxicity after adjuvant treatment for rectal cancer
verfasst von
Matthias Guckenberger
Michael Flentje
Publikationsdatum
01.04.2006
Erschienen in
International Journal of Colorectal Disease / Ausgabe 3/2006
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-005-0765-y

Weitere Artikel der Ausgabe 3/2006

International Journal of Colorectal Disease 3/2006 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.