What are the guideline sources, guidelines and references for Radiation proctitis ?
Guideline sources The following summarized guidelines for the evaluation and management of radiation proctitis are prepared by our editorial team based on guidelines from the Multinational Association of Supportive Care in Cancer (MASCC/ISOO 2020), the American Society for Gastrointestinal Endoscopy (ASGE 2019), the American Society of Colon and Rectal Surgeons (ASCRS 2018), and the European Society of Medical Oncology (ESMO 2015). 1 2 3 4 Guidelines 1. Diagnostic investigations Clinical examination: elicit a disease-specific history and perform a physical examination, emphasizing the degree and duration of bleeding in patients with suspected radiation proctitis. B 2. Medical management Sucralfate enema: As per ASCRS 2018 guidelines, consider administering sucralfate retention enemas for the treatment of bleeding in patients with chronic radiation proctitis. B https://web.pathway.md/diseases/recvpUOQ0My3lmqtC 1/3 6/24/23, 2:56 PM Radiation proctitis Pathway As per ASGE 2015 guidelines, consider administering sucralfate enemas for the treatment of rectal bleeding in patients with chronic radiation proctitis. C Short-chain fatty acid enema: do not use short-chain fatty acid enemas for the prevention or treatment of patients with chronic hemorrhagic radiation proctitis. D Topical formalin: As per ASGE 2019 guidelines, consider avoiding the use of 4% formalin for the treatment of bleeding in patients with chronic radiation proctitis because of higher adverse event rates. D As per ASCRS 2018 guidelines, apply formalin for the treatment of bleeding in patients with chronic radiation prostatitis. B Agents with no evidence for benefit: insufficient evidence to support the use of mesalamine and metronidazole in patients with radiation proctitis. I 3. Therapeutic procedures Endoscopic thermal procedures: As per ASGE 2019 guidelines: Consider offering the following procedures for the treatment of bleeding in patients with chronic radiation proctitis: argon plasma coagulation bipolar electrocoagulation heater probe, and radiofrequency ablation. C Insufficient evidence to recommend a specific endoscopic modality over another. I As per ASCRS 2018 guidelines: Perform endoscopic argon beam plasma coagulation for the treatment of bleeding in patients with chronic radiation proctitis. B Insufficient evidence to recommend endoscopic bipolar electrocoagulation, radiofrequency ablation, or Nd-YAG laser for the treatment of bleeding in patients with chronic radiation proctitis. I Cryoablation: As per ASGE 2019 guidelines, insufficient evidence for or against the use of the newer- generation cryoablation system for the treatment of bleeding in patients with chronic radiation proctitis. I As per ASCRS 2018 guidelines, insufficient evidence to recommend cryotherapy for the treatment of bleeding in patients with chronic radiation proctitis. I Hyperbaric oxygen therapy: As per MASCC 2020 guidelines, consider offering hyperbaric oxygen therapy for the treatment of radiation proctitis in patients with pelvic malignancy. C https://web.pathway.md/diseases/recvpUOQ0My3lmqtC 2/3 6/24/23, 2:56 PM Radiation proctitis Pathway As per ASCRS 2018 guidelines, offer hyperbaric oxygen therapy to reduce bleeding in patients with chronic radiation proctitis. B As per ESMO 2015 guidelines, consider offering hyperbaric oxygen therapy for the treatment of radiation proctitis in patients receiving radiation therapy for a solid tumor. C Ozone therapy: insufficient evidence to support the use of ozone therapy in patients with radiation proctitis. I 4. Preventative measures Amifostine: administer IV amifostine at a dose of 340 mg/m for the prevention of radiation proctitis in patients receiving radiation therapy. B Misoprostol: do not use misoprostol suppositories for the prevention of acute radiation proctitis in patients receiving radiation therapy for prostate cancer. D Preventive surgical adjuncts: insufficient evidence to support the routine use of prophylactic measures, such as pedicled omental flap and tissue expander implant. I References 1. Ian M Paquette, Jon D Vogel, Maher A Abbas et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Chronic Radiation Proctitis. Dis Colon Rectum. 2018 Oct;61 10 1135 1140. Open 2. D E Peterson, C B Boers-Doets, R J Bensadoun et al. Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Ann Oncol. 2015 Sep;26 Suppl 5:v139 51. Open 3. Jeffrey K Lee, Deepak Agrawal, Nirav Thosani et al. ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy. Gastrointest Endosc. 2019 Aug;90 2 171 182.e1. Open 4. Sharon Elad, Karis Kin Fong Cheng, Rajesh V Lalla et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020 Oct 1;126 19 4423 4431. Open https://web.pathway.md/diseases/recvpUOQ0My3lmqtC 3/3