Efficacy of Hyaluronic Acid in Radiation Proctitis: A Case Series
Abstract
Gastrointestinal toxicities of radiation might develop after exposure, thus leading to conditions such as abdominal pain, rectal bleeding, diarrhea, anemia, and weight loss. The development of drugs to reduce mucosal damage progression has been a focus on managing radiation proctitis. Radiation proctitis resulting from exposure to pelvic radiotherapies is effectively managed with topical administration on the anal mucosa. The clinical use of hyaluronic acid offers an innovative approach to managing radiation injury. Hyaluronic acid has multiple beneficial properties, such as regulating immune process to reduce inflammation and oxidative stress, supporting natural protective mechanism, promoting mucosa healing, and improving tissue hydration. Therefore, this case series introduces the idea that application of hyaluronic acid could potentially improve patients’ clinical conditions.
Keywords
References
Williams HRT, Vlavianos P, Blake P, Dearnaley DP, Tait U, Andreyev HJN. The significance of rectal bleeding after pelvic radiotherapy. Aliment Pharmacol Ther. 2005;21(9):1085–90.
Paquette IM, Vogel JD, Abbas MA, Feingold DL, Steele SR. The American society of colon and rectal surgeons clinical practice guidelines for the treatment of chronic radiation proctitis. Dis Colon Rectum. 2018;61(10):1135–40.
Cosentino D, Piro F. Hyaluronic acid for treatment of the radiation therapy side effects: a systematic review. Eur Rev Med Pharmacol Sci. 2018;22(21):7562–72.
Jaffray DA, Gospodarowicz MK. Radiation therapy for cancer. Disease Control Priorities, Third Edition (Volume 3): Cancer. 2015;3:239–47.
Araujo IK, Muñoz-Guglielmetti D, Mollà M. Radiation-induced damage in the lower gastrointestinal tract: Clinical presentation, diagnostic tests and treatment options. Best Practice & Research Clinical Gastroenterology. 2020;48-49:101707.
Ahmed M, Ahmed R. Radiation in gastroenterology. Gastroenterology Research. 2022;15(6):285–96.
Do NL, Nagle D, Poylin VY. Radiation proctitis: current strategies in management. Gastroenterology Research and Practice. 2011;2011:1–9.
Dahiya DS, Kichloo A, Tuma F, Albosta M, Wani F. Radiation proctitis and management strategies. Clinical Endoscopy. 2021.
Jhingran A. Complications of radiation oncology. Principles of Gynecologic Oncology Surgery. 2018;318–29.
Porouhan P, Farshchian N, Dayani M. Management of radiation-induced proctitis. Journal of Family Medicine and Primary Care. 2019;8(7):2173–8.
Lee J, Hee Dong Han, Byung Soh Min, et al. The role of endoscopic evaluation for radiation proctitis in patients receiving intermediate-dose postoperative radiotherapy for rectal cancer. Japanese Jurnal of Oncology. 2018;48(11):988–94.
Fuccio L, Guido A, Andreyev HJN. Management of intestinal complications in patients with pelvic radiation disease. Clinical Gastroenterology and Hepatology. 2012;10(12):1326-1334.e4.
Motte CA, Kessler SP. The role of hyaluronan in innate defense responses of the intestine. International Journal of Cell Biology. 2015;2015:1–5.
Riehl TE, Foster L, Stenson WF. Hyaluronic acid is radioprotective in the intestine through a tlr4 and cox-2-mediated mechanism. American Journal of Physiology. 2012;302(3):G309–16.
Ferini G, Tripoli A, Umina V, et al. Radiation proctitis: The potential role of hyaluronic acid in the prevention and restoration of any damage to the rectal mucosa among prostate cancer patients submitted to curative external beam radiotherapy. Gastroenterology Insights. 2021;12(4):446–55.
Delia P, Sansotta G, Pontoriero A, et al. Clinical evaluation of low-molecular-weight hyaluronic acid-based treatment on onset of acute side effects in women receiving adjuvant radiotherapy after cervical surgery: a randomized clinical trial. Oncol Res Treat. 2019;42(4):212–8.
Laliscia C, Delishaj D, Fabrini MG, et al. Acute and late vaginal toxicity after adjuvant high-dose-rate vaginal brachytherapy in patients with intermediate risk endometrial cancer: is local therapy with hyaluronic acid of clinical benefit? J Contemp Brachytherapy. 2016;8(6):512.
This work is licensed under a