Mallick Supriya, Madan Renu, Julka Pramod K, Rath Goura K
All India Institute of Medical Sciences, New Delhi, India, E-mail :
Asian Pac J Cancer Prev. 2015;16(14):5589-94. doi: 10.7314/apjcp.2015.16.14.5589.
Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.
膀胱炎和直肠炎分别定义为膀胱和直肠的炎症。出血性膀胱炎是放射性和化学性膀胱炎最严重的临床表现。放射性直肠炎和膀胱炎是放疗后的主要并发症。人们已经研究了使用各种口服药物预防放射性出血性膀胱炎，但益处甚微。膀胱冲洗仍然是最常用的方法，其次是膀胱内灌注明矾或福尔马林。在难治性病例中，需要采用输尿管造口术或膀胱切除术等手术干预措施。直肠炎在低剂量范围内甚至更常见，但具有自限性，在中断治疗后会改善。然而，放射性直肠炎的治疗方法大致分为非侵入性或侵入性。非侵入性治疗包括非甾体抗炎药（NSAIDs）、抗氧化剂、硫糖铝、短链脂肪酸和高压氧。侵入性治疗包括如应用福尔马林、内镜YAG激光凝固或氩等离子体凝固等消融手术，手术是最后的手段。
