Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK.
Curr Opin Gastroenterol. 2020 May;36(3):208-214. doi: 10.1097/MOG.0000000000000632.
As cancer treatments improve more patients than ever are living for longer with the side effects of these treatments. Radiation enteritis is a heterogenous condition with significant morbidity. The present review aims to provide a broad overview of the condition with particular attention to the diagnosis and management of the condition.
Radiation enteritis appears to be more prevalent than originally thought because of patient underreporting and a lack of clinician awareness. Patient-related and treatment-related risk factors have now been identified and should be modified where possible. Medical and surgical factors have been explored, but manipulation of the gut microbiota offers one of the most exciting recent developments in disease prevention. Diagnosis and treatment are best approached in a systematic fashion with particular attention to the exclusion of recurrent malignancy and other gastrointestinal conditions. Surgery and endoscopy both offer opportunities for management of the complications of radiation enteritis. Experimental therapies offer hope for future management of radiation enteritis but large-scale human trials are needed.
Radiation enteritis is an important clinical problem, but awareness is lacking amongst patients and physicians. Clinical guidelines would allow standardised management which may improve the burden of the disease for patients.
随着癌症治疗的进步,越来越多的患者在治疗的副作用下能够活得更久。放射性肠炎是一种具有显著发病率的异质性疾病。本综述旨在对该疾病进行广泛概述,特别关注该疾病的诊断和治疗。
由于患者报告不足和临床医生意识缺乏,放射性肠炎的发病率似乎比最初认为的要高。现在已经确定了与患者相关和与治疗相关的风险因素,应尽可能加以改变。已经探讨了医疗和手术因素,但肠道微生物群的操纵为疾病预防的最新发展之一提供了机会。诊断和治疗最好采用系统的方法,特别注意排除复发性恶性肿瘤和其他胃肠道疾病。手术和内镜检查都为放射性肠炎并发症的治疗提供了机会。实验性治疗为放射性肠炎的未来治疗提供了希望,但需要进行大规模的人体试验。
放射性肠炎是一个重要的临床问题,但患者和医生对此认识不足。临床指南将允许进行标准化管理,这可能会改善患者的疾病负担。