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
Previous studies done in animals have shown that significant prophylaxis against radiation injury could be afforded by feeding an elemental diet (ED) for three days before and during radiation. In the present study 20 patients were fed an ED for three days before and for the four days during radiotherapy (five fractions of 400 rad (4 Gy) each) prior to radical cystectomy and ileal conduit for invasive bladder cancer; ED feeding was recommenced 24 hours postoperatively via a feeding jejunostomy. The ED-fed patients exhibited positive nitrogen balance preoperatively and had an early return to positive nitrogen balance postoperatively (3.60 +/- 0.32 days). There was also prompt return of bowel sounds (3.00 +/- 0.32 days). Histologically and ultrastructurally, biopsy specimens of the ileal mucosa showed normal morphologic findings, with maintenance of normal levels of enzyme activity in the brush border. Severe or bloody diarrhea was absent in these patients. These data suggest that ED feeding provides prophylaxis against the acute phase of radiation injury in patients undergoing high-dose, short-course radiotherapy for invasive bladder cancer and that it is a safe and feasible means of postoperative nutritional support, even in the presence of a fresh bowel anastomosis.
- OSTI ID:
- 5014563
- Journal Information:
- Arch. Surg. (Chicago); (United States), Vol. 8
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
DIET
RADIOSENSITIVITY EFFECTS
RADIOTHERAPY
SIDE EFFECTS
BLADDER
CARCINOMAS
ENTERITIS
LARGE INTESTINE
PATIENTS
RADIATION INJURIES
RADIATION PROTECTION
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
RADIATION EFFECTS
RADIOLOGY
THERAPY
URINARY TRACT
560151* - Radiation Effects on Animals- Man
550603 - Medicine- External Radiation in Therapy- (1980-)