• Andrea Hille, Heinz Schmidberger, Robert M Hermann, Hans Christiansen, Bernhard Saile, Olivier Pradier, and Clemens F Hess.
• Department of Radiotherapy and Radiooncology, University of Goettingen, Goettingen, Germany. ahille@med.uni-goettingen.de
• Int. J. Radiat. Oncol. Biol. Phys. 2005 Dec 1; 63 (5): 1488-93.

PurposeAcute radiation proctitis is the most relevant complication of pelvic radiation and is still mainly treated supportively. Considering the negative impact of acute proctitis symptoms on patients' daily activities and the potential relationship between the severity of acute radiation injury and late damage, misoprostol was tested in the prevention of acute radiation-induced proctitis.Methods And MaterialsA total of 100 patients who underwent radiotherapy for prostate cancer were entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. Radiation-induced toxicity was evaluated weekly during radiotherapy using the Common Toxicity Criteria.ResultsBetween the placebo and the misoprostol groups, no significant differences in proctitis symptoms occurred: 76% of patients in each group had Grade 1 toxicity, and 26% in the placebo group and 36% in the misoprostol group had Grade 2 toxicity. No differences were found in onset or symptom duration. Comparing the peak incidence of patients' toxicity symptoms, significantly more patients experienced rectal bleeding in the misoprostol group (p = 0.03).ConclusionMisoprostol given as a once-daily suppository did not decrease the incidence and severity of radiation-induced acute proctitis and may increase the incidence of acute bleeding.

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