Dahiya Dushyant Singh, Kichloo Asim, Tuma Faiz, Albosta Michael, Wani Farah
Department of Internal Medicine, Central Michigan University, Saginaw, MI, USA.
Department of Internal Medicine, Samaritan Medical Center, Watertown, NY, USA.
Clin Endosc. 2022 Jan;55(1):22-32. doi: 10.5946/ce.2020.288. Epub 2021 Nov 18.
Radiotherapy (RT) is a treatment modality that uses high-energy rays or radioactive agents to generate ionizing radiation against rapidly dividing cells. The main objective of using radiation in cancer therapy is to impair or halt the division of the tumor cells. Over the past few decades, advancements in technology, the introduction of newer methods of RT, and a better understanding of the pathophysiology of cancers have enabled physicians to deliver doses of radiation that match the exact dimensions of the tumor for greater efficacy, with minimal exposure of the surrounding tissues. However, RT has numerous complications, the most common being radiation proctitis (RP). It is characterized by damage to the rectal epithelium by secondary ionizing radiation. Based on the onset of signs and symptoms, post-radiotherapy RP can be classified as acute or chronic, each with varying levels of severity and complication rates. The treatment options available for RP are limited, with most of the data on treatment available from case reports or small studies. Here, we describe the types of RT used in modern-day medicine and radiation-mediated tissue injury. We have primarily focused on the classification, epidemiology, pathogenesis, clinical features, treatment strategies, complications, and prognosis of RP.
放射治疗（RT）是一种治疗方式，它利用高能射线或放射性制剂对快速分裂的细胞产生电离辐射。在癌症治疗中使用辐射的主要目的是损害或阻止肿瘤细胞的分裂。在过去几十年中，技术进步、新的放射治疗方法的引入以及对癌症病理生理学的更好理解，使医生能够给予与肿瘤精确尺寸相匹配的辐射剂量，以提高疗效，同时使周围组织的暴露最小化。然而，放射治疗有许多并发症，最常见的是放射性直肠炎（RP）。它的特征是次级电离辐射对直肠上皮造成损伤。根据体征和症状的出现情况，放疗后放射性直肠炎可分为急性或慢性，每种类型的严重程度和并发症发生率各不相同。放射性直肠炎的治疗选择有限，大多数治疗数据来自病例报告或小型研究。在此，我们描述现代医学中使用的放射治疗类型以及辐射介导的组织损伤。我们主要关注放射性直肠炎的分类、流行病学、发病机制、临床特征、治疗策略、并发症和预后。
