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The effect of a combination of Malva sylvestris and Althaea digitata flower powder in prevention of acute radiation proctitis was assessed in patients undergoing radiation therapy (RT) for prostate cancer. This double-blind randomized controlled study was conducted at three centers in Iran. Before starting RT, patients (N = 65) received a 4 g packet of flower powder or placebo to use 3 times a day as an infusion from the first day of RT and for five consecutive weeks including the three weeks of RT. They were visited by a physician 3 times during this period. Acute morbidity was classified according to the Radiation Therapy Oncology Group (RTOG) criteria. Severity of proctitis symptoms was assessed by Visual Analog Scale (VAS) with 10 points. Non-statistical significant differences were observed between the groups in relation to RTOG grade criteria (grade 0: drug 22.8% (N = 8), placebo 10% (N = 3), difference 12.8%; grade 1: drug 65.8%, placebo 64.4%, difference 1.4%; grade 2: drug 11.4% (N = 8), placebo 26.6% (N = 4), difference 15.2%. (P = .059)) According to VAS, the most common complaint was anal burning and diarrhea in the flower powder group showing a significant decrease in these symptoms at the end of the study as compared to the placebo; flower powder (1.56 ± 1.07) vs placebo (3.82 ± 1.67) for burning (P < .05) and flower powder (1.06 ± 0.58) vs placebo (1.95 ± 0.79) for diarrhea (P = .046). The flower powder prevented anal discomfort and diarrhea induced by prostate radiotherapy, although there were no significant differences between the two groups in RTOG. No serious side effects were reported, so the combination could be suggested for patients who cannot tolerate symptoms of proctitis after further studies. [ABSTRACT FROM AUTHOR]

Purpose Radiation received by the testes in the course of radiotherapy for rectal cancer may cause oligospermia and azospermia. We sought to determine the dose to the scrotum and testes with thermoluminescence dosimetry (TLD), and compare it to the dose calculated by 3D planning software. Methods The TLDs were fixed to the scrotum in six points anteriorly and posteriorly in two fractions of radiotherapy. All patients received a 50–50.4 Gy total dose in prone position with 3D-planning. The average dose of TLD measurements was compared to the average of 6 relevant point doses calculated by the planning software. Results The mean scrotal dose of radiation in 33 patients as measured by TLD was 3.77 Gy (7.5% of the total prescribed dose), and the mean of point doses calculated by the planning software was 4.11 Gy (8.1% of the total dose), with no significant difference. A significant relationship was seen between the position of the inferior edge of the fields and the mean scrotal dose (P = .04). Also body mass index (BMI) was inversely related with the scrotal dose (P = .049). Conclusion We found a dose of about 4 Gy received by the scrotum and testes from a total prescribed dose of 50 Gy in the radiotherapy of rectal carcinoma patients, with TLD measurements confirming testicular dose estimations by the planning software. This dose could be significantly harmful for spermatogenesis. Thus careful attention to the testicular dose in radiotherapy of rectal cancer for men desiring continued fertility is a necessity. [ABSTRACT FROM AUTHOR]

Everyday, many patients get radiotherapy for prostatic, rectal, uterine cervix and other pelvic organs cancer. Dysuria is common in pelvic, especially prostate radiotherapy, but there is not any established and confirmed treatment for this therapeutic side effect. Therefore, an alternative therapeutic method, using herbal preparation, may be an effective solution. This study seeks a defensible suggestion in Iranian Traditional Medicine (ITM). In ITM, a few medicinal herbs such as Plantago psyllium, Cydonia oblonga, Portulaca oleracea and some species of Malvaceae and Cucurbitaceae family are indicated in treating dysuria secondary to urethral moisturizing layer defect and inflammatory disorders. Most of these herbs have mucilaginous characteristics and tissue regeneration ability. This choice can be an appropriate one for radiotherapy-induced dysuria as it is produced by a similar pathophysiology with bladder cell layer injury and urethritis. Pharmacological properties such as anti-oxidant, anti-inflammatory, and anti-ulcerogenic activity of the offered herbs make its use justifiable. In lack of sufficient clinical trials to clarify the clinical outcome, further clinical investigation seems to be necessary. [ABSTRACT FROM AUTHOR]