Radiation proctitis in Lagos, Nigeria: A Review of clinical, endoscopic, and pathological findings

Abstract

Background and Objectives: Radiation proctitis (RP) is only sparsely documented as a gastrointestinal side effect of the administration  of radiotherapeutic interventions in oncology practice in Nigerian patients. This review sought to profile important clinical aspects in five  such cases of RP along with a review of the endoscopic and pathological findings.
Materials and Methods: We conducted a retrospective review of all patients who were diagnosed with RP at two Lagos-based privately  run colonoscopy centers. The record examined covered a duration of 36 months (April 1, 2016–May 31, 2019). Over this period, 1035  colonoscopies were carried out, and all RP cases (n = 5) were identified. The clinical presentations and endoscopic findings were  documented as well as the findings of the pathologists’ report for the chronic proctitis (CP) cases.
Results: All patients were in their sixth or seventh decade of life (age range, 63–78 years). There were two males and three females. All  subjects had haematochezia as their presenting complaint. In the case of the two patients with acute RP, bleeding commenced after  initiation of radiotherapy. As for the three patients with CP, the above symptoms started at 7, 11, and 36 months, respectively, after the  last dose of radiotherapy. The time from the onset of the symptom to seeking colonoscopy evaluation varied between 2 and 12 weeks. The histological findings of biopsies of CP were consistent with the diagnosis in the three cases. The endoscopic findings were classified  using the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer criteria.
Conclusion: This study documents the changes related to RP in a cohort of Nigerian patients, with a focus on clinical, endoscopic, and  histopathological findings.