Bowel injury: Current and evolving management strategies

Seminars in Radiation Oncology

Volumn 13, Issue 3, 2003, Pages 358-371

  Hauer Jensen, Martin ^a   Wang, Junru ^b   Denham, James W ^b  

^a UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ACIDIC FIBROBLAST GROWTH FACTOR; AMIFOSTINE; ANTIBIOTIC AGENT; ANTICOAGULANT AGENT; ANTIINFLAMMATORY AGENT; BASIC FIBROBLAST GROWTH FACTOR; COLESTYRAMINE; CYTOKINE; FIBROBLAST GROWTH FACTOR; FIBROBLAST GROWTH FACTOR 1; FIBROBLAST GROWTH FACTOR 2; HEPARIN; INTERLEUKIN 1; INTERLEUKIN 7; KERATINOCYTE GROWTH FACTOR; LOPERAMIDE; OCTREOTIDE; PROKINETIC AGENT; SALAZOSULFAPYRIDINE; SUPEROXIDE DISMUTASE; TRANSFORMING GROWTH FACTOR BETA1; WARFARIN;

CANCER; CANCER RADIOTHERAPY; CLINICAL FEATURE; CONFERENCE PAPER; HUMAN; INTESTINE INJURY; NONHUMAN; PATHOPHYSIOLOGY; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROPHYLAXIS; RADIATION ENTEROPATHY; RADIATION INJURY;

EID: 0042527679     PISSN: 10534296     EISSN: None     Source Type: Journal    
DOI: 10.1016/s1053-4296(03)00032-8     Document Type: Conference Paper

References (140)

1. Kolbl O, Richter S, Flentje M: 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 176:105-111, 2000
2. Nutting CM, Convery DJ, Cosgrove VP, et al: Reduction of small and large bowel irradiation using an optimized intensity-modulated pelvic radiotherapy technique in patients with prostate cancer. Int J Radiat Oncol Biol Plays 48:649-656, 2000
3. Portelance L, Chao KS, Grigsby PW, et al: Intensity-modulated radiation therapy (IMRT) reduces small bowel, rectum, and bladder doses in patients with cervical cancer receiving pelvic and para-aortic irradiation. Int J Radiat Oncol Biol Phys 51:261-266, 2001
4. Mundt AJ, Roeske JC, Lujan AE, et al: Initial clinical experience with intensity-modulated whole-pelvis radiation therapy in women with gynecological malignancies. Gynecol Oncol 82:456-463, 2001
5. Galland RB, Spencer J: The natural history of clinically established radiation enteritis. Lancet 1:1257-1258, 1985
6. Harling H, Balsley I: Long-term prognosis of patients with severe radiation enteritis. Am J Surf 155:517-519, 1988
7. Silvain C, Besson I, Ingrand P, et al: Long-term outcome of severe radiation enteritis treated by total parenteral nutrition. Dig Dis Sci 37:1065-1071, 1992
8. Fischer L, Kimose HH, Spjeldnaes N, et al: Late radiation injuries of the small intestine - Management and outcome. Acta Chir Scand 155:47-51, 1989
9. Kimose HH, Fischer L, Spjeldnaes N, et al: Late radiation injury of the colon and rectum: Surgical management and outcome. Dis Colon Rectum 32:684-689, 1989
10. Regimbeau J-M, Panis Y, Gouzi J-L, et al: Operative and long term results after surgery for chronic radiation enteritis. Am J Surf 182:237-242, 2001
11. Eifel PJ, Levenback C, Wharton JT, et al: Time course and incidence of late complications in patients treated with radiation therapy for FIGO stage IB carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys 32:1289-1300, 1993
12. Letschert JGJ, Lebesque JV, Aleman BMP, et al: 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 32:116-123, 1994
13. Mak AC, Rich TA, Schultheiss TE, et al: Late complications of postoperative radiation therapy for cancer of the rectum and rectosigmoid. Int J Radiat Oncol Biol Phys 28:597-603, 1994
14. Yeoh E, Horowitz M, Russo A, et al: Effect of pelvic irradiation on gastrointestinal function: A prospective longitudinal study. Am J Med 95:397-406, 1993
15. Yeoh E, Sun WM, Russo A, et al: A retrospective study of the effects of pelvic irradiation for gynecological cancer on anorectal function. Int J Radiat Oncol Biol Phys 35:1003-1010, 1996
16. Fransson P, Widmark A: Late side effects unchanged 4-8 years after radiotherapy for prostate carcinoma. Cancer 85:678-688, 1999
17. Fajardo LF. Alimentary tract, in Fajardo LF (ed): Pathology of Radiation Injury. New York, NW, Masson Publishing, 1982, pp 47-76
18. Fajardo LF, Berthrong M, Anderson RE. Alimentary tract, in Fajardo LF, Berthrong M, Anderson RE (eds): Radiation Pathology. New York, NY, Oxford University Press, 2001, pp 209-247
19. Cart KE: Effects of radiation damage on intestinal morphology. Int Rev Cytol 208:1-119, 2001
20. Hauer-Jensen M, Wang J, Denham JW. Mechanisms and modification of the radiation response of gastrointestinal organs, in Milas L, Ang KK, Nieder C (eds): Biological Modification of Radiation Response. Heidelberg, Springer Verlag, 2003
21. Denham JW, Hauer-Jensen M, Peters LJ: Is it time for a new formalism to categorise normal tissue radiation injury? Int J Radiat Oncol Biol Phys 50:1105-1106, 2001
22. Denham JW, Hauer-Jensen M: The radiotherapeutic injury - A complex 'wound". Radiother Oncol 63:129-145, 2009
23. Carratu R, Secondulfo M, de Magistris L, et al: Assessment of small intestinal damage in patients treated with pelvic radiotherapy. Oncol Rep 5:635-639, 1998
24. Hovdenak N, Fajardo LF, Hauer-Jensen M: Acute radiation proctitis: A sequential clinicopathologic study during pelvic radiotherapy. Int J Radiat Oncol Biol Phys 48:1111-1117, 2000
25. Husebye E, Hauer-Jensen M, Kjorstad K, et al: Severe late radiation enteropathy is characterized by impaired motility of proximal small, intestine. Dig Dis Sci 39:2341-2349, 1994
26. Husebye E, Skar V, Hoverstad T, et al: Abnormal intestinal motor patterns explain enteric colonization with gram-begative bacilli in late radiation enteropathy. Gastroenterology 109:1078-1089, 1995
27. Kline JC, Buchler DA, Boone ML, et al: The relationship of reactions to complications in radiation therapy of cancer of the cervix. Radiology 105:413-416, 1972
28. Bourne RB, Kearsley JH, Grove WD, et al: The relationship between early and late gastrointestinal complication of radiation therapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 9:1445-1450, 1983
29. Wang C-J, Leung SW, Chen H-C, et al: The correlation of acute toxicity and late rectal injury in radiotherapy for cervical carcinoma: Evidence suggestive of consequential late effect (CQLE). Int J Radiat Oncol Biol Phys 40:85-91, 1998
30. Weiss E, Hirnle P, Arnold-Bofinger H, et al: Therapeutic outcome and relation of acute and late side effects in the adjuvant radiotherapy of endometrial carcinoma stage I and II. Radiother Oncol 53:37-44, 1999
31. Hauer-Jensen M, Sauer T, Devik F, et al: Effects of dose fractionation on late roentgen radiation damage of rat small intestine. Acta Radiol Oncol 22:381-384, 1983
32. Travis EL, Followill D. The characterization of two types of late effects in irradiated mouse colon, in Chapman JD, Dewey WC, Whitmore GF (eds): Radiation Research. A Twentieth-Century Perspective. San Diego, CA, Academic Press, 1991, pp 154
33. Denham JW, Hauer-Jensen M, Kron T, et al: Treatment time dependence models of early and delayed radiation injury in rat small intestine. Int J Radiat Oncol Biol Phys 48:887, 2000
34. Hauer-Jensen M, Sauer T, Berstad T, et al: Influence of pancreatic secretion on late radiation enteropathy in the rat. Acta Radiol Oncol 24:555-560, 1985
35. Wang J, Zheng H, Sung C-C, et al: The synthetic somatostatin analogue, octreotide, ameliorates acute and delayed intestinal radiation injury. Int J Radiat Oncol Biol Phys 45:1289-1296, 1999
36. Zentler-Munro PL, Bessell EM: Medical management of radiation enteritis - an algorithmic guide. Clin Radiol 38:291-294, 1987
37. Miholic J, Vogelsang H, Schlappack O, et al: Small bowel function after surgery for chronic radiation enteritis. Digestion 42:30-38, 1989
38. Dietz DW, Remzi FH, Fazio WW: Strictureplasty for obstructing small-bowel lesions in diffuse radiation enteritis - successful outcome in five patients. Dis Colon Rectum 44:1772-1777, 2001
39. Denham JW, O'Brien PC, Dunstan RH, et al: Is there more than one late radiation proctitis syndrome? Radiother Oncol 51:43-53, 1999
40. Kochhar R, Patel F, Dhar A, et al: Radiation-induced proctosigmoiditis. Prospective, randomized, double-blind controlled trial of oral sulfasalazine plus rectal steroids versus rectal sucralfate. Dig Dis Sci 36:103-107, 1991
41. O'Brien PC, Franklin CI, Dear KBG, et al: A phase III double-blind randomised study of rectal sucralfate suspension in the prevention of acute radiation proctitis. Radiother Oncol 45:117-123, 1997
42. Martenson JA, Bollinger JW, Sloan JA, et al: Sucralfate in the prevention of treatment-induced diarrhea in patients receiving pelvic radiation therapy: A North Central Cancer Treatment Group phase III double-blind placebo-controlled trial. J Clin Oncol 18:1239-1245, 2000
43. Kneebone A, Mameghan H, Bolin T, et al: The effect of oral sucralfate on the acute proctitis associated with prostate radiotherapy: A double-blind, randomized trial. Int J Radiat Oncol Biol Phys 51:628-635, 2001
44. Pinto A, Fidalgo P, Cravo M, et al: Short chain fatty acids are effective in short-term treatment of chronic radiation proctitis. Dis Colon Rectum 42:788-796, 1999
45. Vernia P, Fracasso PL, Casale V, et al: Topical butyrate for acute radiation proctitis: Randomised, crossover trial. Lancet 356:1232-1235, 2000
46. Rubinstein E, Ibsen T, Rasmussen RB, et al: Formalin treatment of radiation-induced hemorrhagic proctitis. Am J Gastroenterol 81:44-45, 1986
47. Saclarides TJ, King DJ, Franklin JL, et al: Formalin instillation for refractory radiation-induced hemorrhagic proctitis. Dis Colon Rectum 39:196-199, 1996
48. Counter SF, Froese DP, Hart MJ: Prospective evaluation of formalin therapy for radiation proctitis. Am J Surg 177:396-398, 1999
49. Jensen DM, Machicado GA, Cheng S, et al: A randomized prospective study of endoscopic bipolar electrocoagulation and heater probe treatment of chronic rectal bleeding from radiation telangiectasia. Gastrointest Endosc 45:20-25, 1997
50. Leuchter RS, Petrilli ES, Dwyer RM, et al: Nd: YAG laser therapy of rectosigmoid bleeding due to radiation injury. Obstet Gynecol 59(S6):65-67, 1982
51. Taylor JG, Disario JA, Buchi KN: Argon laser therapy for hemorrhagic radiation proctopathy: Long term results. Gastrointest Endoscopy 39:641-644, 1993
52. Carbatzas C, Spencer GM, Thorpe SM, et al: Nd: Yag laser treatment for bleeding from radiation proctitis. Endoscopy 28:497-500, 1996
53. Taylor JG, Disario JA, Bjorkman DJ: KTP laser therapy for bleeding from chronic radiation proctopathy. Gastrointest Endosc 52:353-357, 2000
54. Fantin AC, Binek J, Suter WR, et al: Argon beam coagulation for treatment of symptomatic radiation-induced proctitis. Gastrointest Endosc 49:515-518, 1999
55. Tam W, Moore J, Schoeman M: Treatment of radiation proctitis with argon plasma coagulation. Endoscopy 32:667-672, 2000
56. Smith S, Wallner K, Dominitz JA, et al: Argon beam coagulation for rectal bleeding after prostate brachytherapy. Int J Radiat Oncol Biol Phys 51:636-646, 2001
57. Kaassis M, Oberti E, Burtin P, et al: Argon plasma coagulation for the treatment of hemorrhagic radiation proctitis. Endoscopy 32:673-676, 2002
58. Zimmermann FB, Feldmann HJ: Radiation proctitis. Clinical and pathological manifestations, therapy and prophylaxis of acute and late injurious effects of radiation on the rectal mucosa. Strahlenther Onkol 174(S3): 85-89, 1998
59. Feldmeier JJ, Heimbach RD, Davolt DA, et al: Hyperbaric oxygen an adjunctive treatment for delayed radiation injuries of the abdomen and pelvis. Undersea Hyperb Med 24:215-216, 1996
60. Epperly MW, Travis EL, Sikora C, Greenberger JS: Magnesium superoxide dismutase (MnSOD) plasmid/liposome pulmonary radioprotective gene therapy: Modulation of irradiation-induced mRNA for IL-I, TNF-a, and TGF-b correlates with delay of organizing alveolitis/fibrosis. Biol Blood Marrow Transplant 5:204-214, 1999
61. Stickle RL, Epperly MW, Klein E, et al: Prevention of irradiation-induced esophagitis by plasmid/liposome delivery of the human manganese superoxide dismutase transgene. Radiat Oncol Invest 7:204-217, 1999
62. Lefaix JL, Delanian S, Leplat JJ, et al: Successful treatment of radiation-induced fibrosis using Cu/ZN-SOD and Mn-SOD: an experimental study. Int J Radiat Oncol Biol Phys 35:305-312, 1996
63. Delanian S, Baillet F, Huart J, et al: Successful treatment of radiation-induced fibrosis using liposomal Cu/Zn superoxide dismutase: Clinical trial. Radiother Oncol 32:12-20, 1994
64. Lindegaard JC, Grau C: Has the outlook improved for amifostine as a clinical radioprotector? Radiother Oncol 57:113-118, 2000
65. Ito H, Meistrich ML, Barkley T, et al: Protection of acute and late radiation damage of the gastrointestinal tract by WR-2721. Int J Radiat Oncol Biol Phys 12:211-219, 1986
66. Carroll MP, Zeta RT, Roberts JC, et al: Efficacy of radioprotective agents in preventing small and large bowel radiation injury. Dis Colon Rectum 38:716-722, 1995
67. Delaney JP, Bonsack ME, Felemovicius I: Radioprotection of the rat small intestine with topical WR-2721. Cancer 74:2379-2384, 1994
68. Ben-Joseph E, Han S, Tobi M, et al: Intrarectal application of amifostine for the prevention of radiation-induced rectal injury. Semin Radiat Oncol 12:81-85, 2002
69. Caroll MP, Zera RT, Roberts JC, et al: Efficacy of radioprotective agents in preventing small and large bowel radiation injury. Dis Colon Rectum 38:716-722, 1995
70. Rowe JK, Zeta RT, Madoff RD, et al: Protective effect of RibCys following high-dose irradiation of the rectosigmoid. Dis Colon Rectum 36:681-688, 1993
71. Delaney JP, Bonsack M, Hall P: Intestinal radioprotection by two new agents applied topically. Ann Surg 216:417-422, 1992
72. Felemovicius I, Bonsack ME, Griffin RJ, et al: Radioprotection of the rat intestinal mucosa by tirilazad. Int J Radiat Biol 73:219-223, 1998
73. Bonsack WE, Felemovicius I, Baptista ML, et al: Radioprotection of the intestinal mucosa of rats by probucol. Radiat Res 151:69-73, 1999
74. Beyzadeoglu M, Balkan M, Demiriz M, et al: Protective effect of vitamin A on acute radiation injury in the small intestine. Radiat Med 15:1-5, 1997
75. Felemovicius I, Bonsack ME, Baptista ML, et al: Intestinal radioprotection by vitamin E (alpha-tocopherol). Ann Surg 222:504-510, 1995
76. Dion MW, Hussey DH, Doornbos JF, et al: Preliminary results of a pilot study of pentoxifylline in the treatment of late radiation soft tissue necrosis. Int J Radiat Oncol Biol Phys 19:401-407, 1990
77. Delanian S, Balla-Mekias S, Lefaix JL: Striking regression of chronic radiotherapy damage in a clinical trial of combined pentoxifylline and tocopherol. J Clin Oncol 17:3283-3290, 1999
78. Koh W, Stelzer KJ, Peterson LM, et al: Effect of pentoxifylline on radiation-induced lung and skin toxicity in rats. Int J Radiat Oncol Biol Phys 31:71-77, 1994
79. Tamou S, Trott KR: Modification of late radiation damage in the rectum of rats by deproteinized calf blood serum (ActoHorm) and pentoxifylline (PTX). Strahlenther Onkol 170:415-420, 1994
80. Hanson WR, Thomas C: 16,16-Dimethyl Prostaglandin E2 increases survival of murine intestinal stem cells when given before photon radiation. Radiat Res 96:393-398, 1983
81. Tomas-de la Vega JE, Banner BF, Hubbard M, et al: Cytoprotective effect of prostaglandin E2 in irradiated rat ileum. Surg Gynecol Obstet 158:39-45, 1984
82. Keelan M, Walker K, Cheeseman CI, et al: Two weeks of oral synthetic E2 prostaglandin (enprostil) improves the intestinal morphological but not the absorptive response in the rat to abdominal irradiation. Digestion 53:101-107, 1992
83. Delaney JP, Bonsack ME, Felemovicius I: Misoprostol in the intestinal lumen protects against radiation injury of the mucosa of the small bowel. Radiat Res 137:405-409, 1994
84. Khan AM, Birk JW, Anderson JC, et al: A prospective randomized placebo-controlled double-blinded pilot study of misoprostol rectal suppositories in the prevention of acute and chronic radiation proctitis syndrome in prostate cancer patients. Am J Gastroenterol 93:1961-1966, 2000
85. Cohen S, Bigazzi PE, Yoshida T: Similarities of T cell function in cell-mediated immunity and antibody production. Cell Immunol 12:150-159, 1974
86. Wu SG, Miyamoto T: Radioprotection of the intestinal crypts of mice by recombinant human interleukin-1 alpha. Radiat Res 123:112-115, 1990
87. Hancock SL, Chung RT, Cox RS, et al: Interleukin 1 beta initially sensitizes and subsequently protects routine intestinal stem cells exposed to photon radiation. Cancer Res 51:2280-2285, 1991
88. Welniak LA, Khaled AR, Anver MR, et al: Gastrointestinal cells of IL-7 receptor null mice exhibit increased sensitivity to irradiation. J Immunol 166:2923-2928, 2001
89. Potten CS: Protection of the small intestinal clonogenic stem cells from radiation-induced damage by pretreatment with interleukin 11 also increases murine survival time. Stem Cells 14:452-459, 1996
90. Potten CS: Interleukin-11 protects the clonogenic stem cells in routine small-intestinal crypts from impairment of their reproductive capacity by radiation. Int J Cancer 62:356-361, 1995
91. Orazi A, Du X, Yang Z, et al: Interleukin-11 prevents apoptosis and accelerates recovery of small intestinal mucosa in mice treated with combined chemotherapy and radiation. Lab Invest 75:33-42, 1996
92. Okunieff P, Mester M, Wang J, et al: In vivo radioprotective effects of angiogenic growth factors on the small bowel of C3H mice. Radiat Res 150:204-211, 1998
93. Paris F, Fuks Z, Kang A, et al: Endothelial apoptosis as the primary lesion initiating intestinal radiation damage in mice. Science 293:293-297, 2001
94. Houchen CW, George RJ, Sturmoski MA, et al: FGF-2 enhances intestinal stem cell survival and its expression is induced after radiation injury. Am J Physiol 39:G249-G258, 1999
95. Farrell CL, Bready JV, Rex KL, et al: Keratinocyte growth factor protects mice from chemotherapy and radiation-induced gastrointestinal injury and mortality. Cancer Res 58:933-939, 1998
96. Khan WB, Shui C, Ning S, et al: Enhancement of murine intestinal stem cell survival after irradiation by keratinocyte growth factor. Radiat Res 148:248-253, 1997
97. Zheng H, Wang J, Koteliansky VE, et al: Recombinant soluble transforming growth factor-b type II receptor ameliorates radiation enteropathy in the mouse. Gastroenterology 119:1286-1296, 2000
98. Weinblatt ME, Kremer JM, Bankhurst AD, et al: A trial of etanercept, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med 340:253-259, 1999
99. Arango V, Ettarh RR, Holden G, et al: BB-10010, an analog of macrophage inflammatory protein-1a, protects routine small intestine against radiation. Dig Dis Sci 46:2608-2614, 2001
100. Leigh BR, Khan W, Hancock SL, et al: Stem cell factor enhances the survival of murine intestinal stemm cells after photon irradiation. Radiat Res 142:12-15, 1995
101. Howarth GS, Fraser R, Frisby CL, et al: Effects of insulin-like growth factor-I administration on radiation enteritis in the rat. Scand J Gastroenterol 32:1118-1124, 1997
102. Vazquez I, Gomez-de-Segura IA, Grande AG, et al: Protective effect of enriched diet plus growth hormone administration on radiation-induced intestinal injury and on its evolutionary pattern in the rat. Dig Dis Sci 44:2350-2358, 1999
103. Silver DF, Simon A, Dubin NH, et al: Recombinant growth hormone's effects on the strength and thickness of radiation-injured ileal anastomoses: A rat model. J Surg Res 85:66-70, 1999
104. Brown MS, Buchanan RB, Karran SJ: Clinical observations on the effects of elemental diet supplementation during irradiation. Clin Radiol 31:19-20, 1980
105. Craighead PS, Young S: Phase II study assessing the feasibility of using elemental supplements to reduce acute enteritis in patients receiving radical pelvic radiotherapy. Am J Clin Oncol 21:573-578, 1998
106. Douglass HO, Milliron S, Nava H, et al: Elemental diet as an adjuvant for patients with locally advanced gastrointestinal cancer receiving radiation therapy: A prospectively randomized study. Jpn J Parenter Enteral Nutr 2:682-686, 1978
107. Foster KJ, Brown MS, Alberti KG, et al: The metabolic effects of abdominal irradiation in man with and without dietary therapy with and elemental diet. Clin Radiol 31:13-17, 1980
108. McArdle AH, Reid EC, Laplante MP, et al: Prophylaxis against radiation injury. The use of elemental diet prior to and during radiotherapy for invasive bladder cancer and in early postoperative feeding following radical cystectomy and ileal conduit. Arch Surg 121:879-885, 1986
109. Klimberg VS, Souba WW, Olson DJ, et al: Prophylactic glutamine protects intestinal mucosa from radiation injury. Cancer 66:62-68, 1990
110. Campos FG, Waitzberg DL, Mucerino DR, et al: Protective effects of glutamine enriched diets on acute actinic enteritis. Nutr Hosp 11:167-177, 1996
111. McArdle AH: Elemental diets in treatment of gastrointestinal injury. Adv Biosci 94:201-206, 1994
112. Huang EY, Leung SW, Wang CJ, et al: Oral glutamine to alleviate radiation-induced oral mucositis: A pilot randomized trial. Int J Radiat Oncol Biol Phys 46:535-539, 2000
113. Gurbuz AT, Kunzelman J, Ratzer EE: Supplemental dietary arginine accelerates intestinal mucosal regeneration and enhances bacterial clearance following radiation enteritis in rats. J Surg Res 74:149-154, 1998
114. Ersin S, Tuncyurek P, Esassolak M, et al: The prophylactic and therapeutic effects of glutamine- and arginine-enriched diets on radiation-induced enteritis in rats. J Surg Res 89:121-125, 2000
115. Mennie AT, Dalley VM, Dinneen LC, et al: Treatment of radiation-induced gastrointestinal distress with acetylsalicylate. Lancet 2:942-943, 1975
116. Stryker JA, Demers LM, Mortel R: Prophylactic ibuprofen administration during pelvic irradiation. Int J Radiat Oncol Biol Phys 5:2049-2052, 1979
117. Kilic D, Egehan I, Ozenirler S, et al: Double-blinded, randomized, placebo-controlled study to evaluate the effectiveness of sulphasalazine in preventing acute gastrointestinal complications due to radiotherapy. Radiother Oncol 57:125-129, 2000
118. Frennd U, Scholmerich J, Siems H, et al: Unwanted side-effects in using mesalazine (5-aminosalicylic acid) during radiotherapy. Strahlenther Onkol 163:678-680, 1987
119. Baughan CA, Canney PA, Buchanan RB, et al: A randomized trial to assess the efficacy of 5-aminosalicylic acid for the prevention of radiation enteritis. Clin Oncol 5:19-24, 1993
120. Martenson JA, Hyland G, Moertel CG, et al: Olsalazine is contraindicated during pelvic radiation therapy: Results of a double-blind randomized clinical trial. Int J Radiat Oncol Biol Phys 35:299-303, 1996
121. Resbeut M, Marteau P, Cowen D, et al: A randomized double blind placebo controlled multicenter study of mesalazine for the prevention of acute radiation enteritis. Radiother Oncol 44:59-63, 1997
122. Baum CA, Biddle WL, Miner PB: Failure of 5-aminosalicylic acid enemas to improve chronic radiation proctitis. Dig Dis Sci 34:758-760, 1989
123. Krause P, Ziegler K: Experimentelle untersuchungen ueber die einwirkung der roentgenstrahlen auf tierische gewebe. A. Uebersicht ueber die in der litteratur niedergelegten angaben ueber die wirkung der roentgenstrahlen auf innere Organe. Fortschr a d Geb d Roentgenstr 10:126-182, 1906
124. Salminen E, Elomaa I, Minkkinen J, et al: Preservation of intestinal integrity during radiotherapy using live Lactobacillus acidopheles cultures. Clin Radiol 39:435-437, 1988
125. Sokol AB, Lipson LW, Morgenstern L, Hiatt N: Protection against lethal irradiation injury by pancreatic enzyme exclusion. Surg Forum 18:387-389, 1967
126. Morgenstern L, Patin CS, Krohn HL, et al: Prolongation of survival in lethally irradiated dogs. Arch Surg 101:586-589, 1970
127. Rachootin S, Shapiro S, Yamakawa T, et al: Potent anti-protease from Ascaris lumbricoides: Efficacy in amelioration of post-radiation enteropathy. Gastroenterology 62:796(abstr), 1972
128. Wang J, Zheng H, Hauer-Jensen M: Influence of short-term octreotide administration on chronic tissue injury, transforming growth factor b (TGF-b) overexpression, and collagen accumulation in irradiated rat intestine. J Pharmacol Exp Ther 297:35-42, 2001
129. Weckbecker G, Liu R, Tolcsvai L, et al: Antiproliferative effects of the somatostatin analogue octreotide (SMS 201-995) on ZR-75-1 human breast cancer cells in vivo and in vitro. Cancer Res 52:4973-4978, 1992
130. Weckbecker G, Tolcsvai L, Liu R, et al: Preclinical studies on the anticancer activity of the somatostatin analogue octreotide (SMS 201-995). Metabolism 41:99-103, 1992 (Suppl 2)
131. Weckbecker G, Tolcsvai L, Pollak M, et al: Somatostatin analogue octreotide enhances the antineoplastic effects of tamoxifen and ovariectomy on 7,12-dimethylbenz(a)-anthracene-induced rat mammary carcinomas. Cancer Res 54:6334-6337, 1994
132. Patel PC, Barrie R, Hill N, et al: Postreceptor signal transduction mechanisms involved in octreotide-induced inhibition of angiogenesis. Surgery 116:1148-1152, 1994
133. Wang J, Albertson CM, Zheng H, et al: Short-term inhibition of ADP-induced platelet aggregation by clopidogrel ameliorates radiation-induced toxicity in rat small intestine. Thromb Haemost 87:122-128, 2002
134. Albertson CM, Wang J, Zheng H, et al: Recombinant hirudin, a direct thrombin inhibitor, ameliorates radiation enteropathy. Am J Clin Pathol 114:300, 2000 (abstr)
135. Christensen HD, Haley TJ: Distribution of substance P in the central nervous system and small intestine of the rat after X-irradiation. Radiat Res 33:588-595, 1968
136. Esposito V, Linard C, Maubert C, et al: Modulation of gut substance P after whole-body irradiation. A new pathological feature. Dig Dis Sci 41:2070-2077, 1996
137. Hockerfelt U, Franzen L, Kjorell U, et al: Parallel increase in substance P and VIP in rat duodenum in response to irradiation. Peptides 21:271-281, 2000
138. Forsgren S, Hockerfelt U, Norrgard O, et al: Pronounced substance P innervation in irradiation-induced enteropathy - A study on human colon. Regul Pept 88:1-13, 2000
139. Esposito V, Linard C, Wysocki J, et al: A substance P receptor antagonist (FK 888) modifies gut alterations induced by ionizing radiation. Int J Radiat Biol 74:625-632, 1998
140. Alfieri AB, Gardner CJ: Effects of GR203040, an NK1 antagonist, on radiation- and cisplatin-induced tissue damage in the ferret. Gen Pharmacol 31:741-746, 1998