Covens et al evaluated patients with radiation-induced bowel injury who required surgical management. They identified risk factors affecting survival for these patients. The authors are from the University of Toronto, Toronto-Bayview Regional Cancer Centre, Wellesley Hospital, and Princess Margaret Hospital in Toronto.


Types of radiation-induced injuries included:

(1) stricture

(2) perforation

(3) fistula

(4) inflammation


Risk factors affecting survival after surgery:

(1) ileal involvement (most important single factor)

(2) multiple sites involved

(3) multiple types of injuries

(4) anastomosis performed


Additional risk factors such as nutritional status, metastatic disease, age, ischemic bowel disease, etc will also impact survival.

Recommendation: Try to avoid bowel injury during radiation therapy, especially damage to the ileum.


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