ISSN : 2146-3123
E-ISSN : 2146-3131

The Protective Effect of Amifostine on Radiation-Induced Proctitis: Systemic Versus Topical Application
Cem Uzal 1, Ruşen Coşar Alas 2, Ufuk Usta 3, Necdet Süt 4, Alaattin Özen 5, Mehmet Ali Yağcı 6
1Department of Radiation Oncology, Faculty of Medicine, Trakya University, , Edirne, Turkey
2Trakya Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Edirne, Türkiye
3Departments of Pathology, Medical Faculty of Trakya University, Edirne
4Departments of Biostatistics, Medical Faculty of Trakya University, Edirne
5Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
6Department of Surgery, Faculty of Medicine, Trakya University Edirne, Turkey
DOI : 10.5152/balkanmedj.2011.005

Abstract

Objective: The aim of the study was to evaluate the radioprotective efficacy of intrarectal administration of amifostine in radiation-induced proctitis compared to intraperitoneal administration.

Materials and Methods: Thirty-two Sprague-Dawley rats were randomly divided into four groups: Control (CONT), irradiation alone (RT), intraperitoneal amifostine plus irradiation (IPAMI), and intrarectal amifostine plus irradiation (IRAMI). The rats in the RT, IPAMI and IRAMI groups were irradiated individually with a single dose of 17.5 Gy to the pelvis. Amifostine was administered by the intraperitoneal (200 mg/kg) or intrarectal (2000 mg/kg) route before irradiation. Histopathologic analysis of the rectum was performed 14 days after irradiation.

Results: Significant radiation damage appeared in all histopathologic parameters and was reduced by amifostine. Pretreatment with IPAMI significantly reduced the inflammatory infiltrate in the lamina propria (p=0.021), cryptitis (p=0.002) and crypt abscess (p=0.015). However, the protective effect of IRAMI was significant for all parameters with equal or higher significance than IPAMI, including the eosinophil leucocytes count (p=0.02), and distortion of the crypts (p=0.008), and was also significant for regenerative/reparative atypia (p=0.013).

Conclusion: Intrarectal high dose topical administration of amifostine is more effective in the prevention of radiation-induced proctitis compared to its intraperitoneal systemic administration.

Keywords : Amifostine, proctitis, irradiation, radioprotection
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