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Objective::To discuss the efficacy of compound Huangteng mixture for acute radiation enteritis (ARE) and to investigate its regulatory effect on serum inflammatory factors. Method::One hundred and forty patients were randomly divided into control group (70 cases) and observation group (70 cases) by random number table. Patients in control group got precise radiotherapy. And take montmorillorillonite powder orally based on the treatment in control group, patients in observation group additionally received compound Huangteng mixture, 1 dose/day. The treatment was continued to the second week after the ending of radiotherapy in both groups. Time of appearance of ARE (1 and 2 levels), irradiation dose and incidence of severe ARE (3 and 4 levels) were recorded. Endoscope examination was conducted at the second week after the ending of radiotherapy. ARE symptom scores and KPS scores of quality of life were graded. Levels of serum interleukin-1 (IL-1), IL-4, IL-6, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were detected both before and after treatment. Result::Time of appearance of ARE (1 and 2 levels) in observation group was shorter than those in control group (P<0.01), and irradiation dose was more than that in control group (P<0.01). At the fourth and fifth week of radiotherapy and at the second week after the ending of radiotherapy, incidence rate of ARE (levels 2 and above) was 42.86%(30/70), 50.00%(35/70) and 54.29%(38/70), all lower than 61.43%(43/70), 68.57%(48/70) and 74.29%(52/70) in control group (χ2=4.837, P<0.05, χ2=5.001, P<0.05, χ2=6.097, P<0.05). After radiotherapy, incidence of ARE was 62.86%(44/70) in observation group, lower than 78.57%(55/70) in control group (χ2=4.173, P<0.05), and the incidence of severeARE was 13.64%(6/44) in observation group, lower than 32.73%(18/55) in control group (χ2=4.851, P<0.05). Scores of endoscope and ARE symptoms in observation group were lower than those in control group, while score of KPS was higher than that in control group (P<0.01). After radiotherapy, levels of IL-1, IL-6, TNF-α and CRP in observation group were lower than those in control group (P<0.01), while level of IL-4 was higher than that in control group (P<0.01). Conclusion::Compound Huangteng mixture combined with radiotherapy can reduce the incidence of ARE, postpone the occurrence of ARE, relieve the severity of ARE, regulate the expression of inflammatory factors, alleviate clinical symptoms, and improve the quality of life in patients withradiotherapy, thus it is conducive to the sequential development of radiotherapy.
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Objective To investigate the relationship between the body mass index (BMI)/body mass index improved (BMIIMPd) and the dose of the small intestine as well as the acute radiation colitis in the intensity-modulated radiation therapy after cervical cancer surgery.Methods Thirty-nine cervical cancer patients underwent postoperative adjuvant radiotherapy.All patients received Philips large bore CT scan for enhanced CT scan,target delineation and organ at risk.All patients were treated with a single arc 10 MV VMAT plan.The correlation between the radiation dose of the small intestine and the acute radiation enteritis and BMI/BMIIMPd was analyzed.Results The BMI was calculated as (22.23±2.80) kg/m2,BMIIMPd was (21.49±3.95) kg/m2,the small intestine volume VSI was (1 155.71 ± 419.33)cc3.The volume of the small intestine received more than 10 Gy (V10_SI) VMAT was (66.50± 27.01) ％,and the equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were (4 098.87± 184.93) cGy and (7.98±8.73)％.One way ANOVA demonstrated that under the VMAT technology,the BMIIMPd,V30,V40,EUD (or=50) and NTCP in the small intestine were the influencing factors of the occurrence of acute radiation enteritis.Conclusions If the improved BMIIMPd is utilized to distinguish the BMI,the high dose area of the small intestine will be larger and the incidence of acute radiation enteritis will be higher for patients with BMIIMPd between 10.1 and 16.9(normal and thin).Conventional BMI cannot be utilized as a basis for the prediction of the incidence of acute radiation enteritis in patients with cervical carcinoma.
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Objective To investigate the reliable methods for establishing models of acute radiation enteritis (ARE) and the criteria used to judge whether the model is successfully established.Methods A total of 98 rats were randomly divided into normal control group (group A),fractionated dose group B (4 Gy/fraction for 3 fractions),fractionated dose group C (4 Gy/fraction for 4 fractions),fractionated dose group D (4 Gy/fraction for 5 fractions),single fraction group E (12 Gy in a single fraction),single fraction group F (16 Gy in a single fraction),and single fraction group G (20 Gy in a single fraction).Abdominal irradiation was performed for all rats,and the changes in body weight and defecation were observed.Magnetic resonance imaging (MRI) was performed on days 3-5 after irradiation,and on the 4th day,anatomy was performed to measure the length of small intestine with edema,blood samples were collected to measure endotoxins,and the specimens of small intestine were collected to observe pathological changes.The independent-samples t-test was used for comparison between groups.Results After irradiation,groups D,E,F,and G experienced varying degrees of diarrhea and had positive results from endotoxins test.Group D had a longer length of small intestine with edema than group C (P=0.00) and had a similar length as group E (P=0.46).Groups E,F,and G showed dilation and dropsy in the intestinal canal on MRI,and groups F and G showed patchy signals of dropsy in the abdominal cavity.Groups F and G showed varying degrees of necrosis in the small intestine and died within 14 days after irradiation.Conclusions When the radiation dose is 33-46 Gy (biologically equivalent dose),both single dose and fractionated dose can successfully establish the model of ARE,while fractionated dose can be better controlled.
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Objective To observe the prevention effect of glutathione on acute radiation enteritis in pelvic radiation therapy.Methods All 80 pelvic tumor patients treated with radiotherapy were randomly assigned to the control group (40 patients)and the treatment group (40 patients)by the number table method.40 cases in the con-trol group treated with radiation were not treated with preventive drugs,but the patients in the treatment group were treated with glutathione.The occurrence time of acute radiation enteritis and the severity of acute radiation enteritis after treatment were evaluated.Results 15.0% of the treatment group suffered from acute radiation enteritis in the second week and 72.5% in the third week.however,62.5% of the control group were suffered from acute radiation enteritis in the second week and 27.5% in the third week.The difference was statistically significant (χ2 =18.775, 15.998,all P <0.001).Glutathione delayed the occurrence time of acute radiation enteritis.The grade 1 and grade 2 acute radiation enteritis effective rate in the treatment group were 77.5% and 17.5%,and that in the control group were 20.0% and 72.5%,the difference between the two groups was significant(χ2 =26.136,24.139,all P <0.001).The glutathione could reduce the incidence of acute radiation enteritis extent.Conclusion Glutathione could delay the occurrence time of acute radiation enteritis and reduce the incidence of acute radiation enteritis extent.It is worth clinical application.
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Objective To investigate the therapeutic effects of Erqi decoction (EQD) for treatment of acute radiation enteritis in SD rats and the related mechanism. Methods A total of 53 SD rats were randomly divided into normal group model group, EQD group and Baitouwengtang (BTWT) group, with 8 rats in the normal control group and 15 in each of the rest groups. Rats in the latter three groups were exposed to a single dose of 10 Gy 6 MV higher-energy X-rays on the abdominal region to establish the acute radiation enteritis models. Then all the rats were intragastrically administered with corresponding agents for a consecutive of 7 days. Then 10 ml ileum samples in ileocecal junction were obtained from each animal under general anesthesia. The morphologic indiceswere examined by light microscopy and the image analysis system. The nitric oxide (NO) levels, superoxide dismutase (SOD) activities and malondialdehyde (MDA) levels in the small intestinal homogenates were measured by spectrophotometer. Results The EQD group had significantly higher villus height ([243±9] vs [211 ±21] μm), deeper crypt ([171 ± 12] vs [142±10] μm), thicker mucosa ([460±21] vs [420±37] μm) and entirewall thickness ([609±19] vs [569 ±21] (μm) than the model group (P<0. 05), and the above parameters were not significantly different between the EQD group and the BTWT group. EQ group had significantly lower NO level ([0. 88 ± 0. 11] vs [1. 65 ±0. 12] μmol/g), higher MDA level ([3. 20±0. 12] vs [4. 75±0. 24] nmol/mg) and lower SOD activity ([212±13] vs [150± 11] U/mg, P< 0. 05) in the intestine compared with the model group (P<0. 05). EQD group had significantly lower NO and MDA levels and higher SOD activity compared with the BTWT group (P<0. 05). Conclusion It is indicated that EQD has protective effect against intestine mucosa damage in acute radiation enteritis rat model by reducing the intestinal NO generation, improving intestinal SOD activity, reducing MDA generation. Anti-free radical injury may be one of the mechanisms for treatment of acute radiation enteritis.