Thalidomide in refractory haemorrhagic radiation induced proctitis

One of the most frequently encountered late gastrointestinal sequelae of abdominopelvic radiation therapy is radiation proctitis, occurring in 12.5–19% of patients.1,2 Treatment options range from drug therapy, including spasmolytics, steroids, mesalasin, and endoscopic treatment comprising argon plasma coagulation (APC), laser coagulation, and formalin application, to hyperbaric oxygen therapy and finally surgical intervention.3–5 We describe a patient with severe refractory haemorrhagic radiation proctitis requiring frequent blood transfusions who was successfully treated with low dose oral thalidomide. A 78 year old female presented with a three month history of intermittent rectal blood loss. Her medical history revealed cervical cancer stage IIIB two years earlier. She had been treated with a multimodal regimen comprising chemotherapy (cisplatin 40 mg/m2 at …