This clinical trial aims to evaluate the efficacy and safety of Kangfupen (a topical liquid dressing) in treating chronic radiation-induced proctitis (RTOG Grade 2 or higher). The key questions we aim to answer are: 1. Does Kangfupen improve LENT-SOMA rectal injury scores after 3 months of treatment? 2. Does Kangfupen reduce endoscopic inflammation (Vienna score) and symptoms (RTOG/CTCAE grades)? 3. What adverse events occur with Kangfupen therapy? Kangfupen liquid dressing (50 mL/once daily) will be administered as retention enema for 3-6 months, adjusted based on lesion location. Researchers will evaluate the following outcomes to assess Kangfupen's efficacy and safety in treating chronic radiation proctitis: 1. Change in LENT-SOMA rectal injury score (baseline vs. 3 months). 2. Changes in Vienna endoscopic score, RTOG/CTCAE grades, and IBDQ quality-of-life scores. 3. Symptom improvement rate and time to complete remission. Participant will: 1. Undergo baseline and 3-month endoscopic evaluations. 2. Complete symptom diaries and quality-of-life questionnaires. 3. Attend regular clinic visits for safety monitoring.
Baseline Assessments All enrolled patients must complete the following evaluations: 1. Medical history including primary tumor type, histopathology, staging and radiotherapy details (timing, technique, and total dose) 2. Physical examination 3. ECOG performance status 4. Laboratory tests including complete blood count, stool occult blood, liver/kidney function and tumor markers 5. Pelvic scans to exclude tumor recurrence/progression 6. Full colonoscopy with photographic documentation. Images every 5cm from anus to splenic flexure, and at sites of severe mucosal reaction additionally 7. Grading based on LENT-SOMA, RTOG, and CTCAE v5.0 criteria Treatment protocol Kangfupen (liquid dressing) retention enema * Dosage: 50 mL once daily for 3-6 months * Administration depth: Determined by colonoscopy findings Enema preparation \& administration 1. Reconstitution: 1. Transfer liquid from plastic to brown glass vial 2. Shake vigorously to dissolve lyophilized powder 3. Return solution to plastic bottle and shake again 2. Delivery: <!-- --> 1. Position: Left lateral decubitus with waste basin 2. Slowly instill 50 mL into rectum 3. Retain for ≥30 minutes, rotating positions every 15 minutes (left/right lateral, supine, knee-chest) Concomitant therapies Permitted: probiotics, smectite, antibiotics, stool softeners Prohibited: 5-ASA drugs (mesalazine/sulfasalazine), endoscopic hemostasis (e.g., argon plasma coagulation), formaldehyde/HBO/surgery/fecal microbiota transplant, other enema therapies. Toxicity monitoring Potential adverse events include allergic reactions and mechanical injury (bleeding/perforation). Required Actions include immediately discontinuing treatment and reporting to the principal investigating site within 24 hours. All adverse events will be assessed using CTCAE v5.0 criteria. Follow-up schedule Month 1-2: LENT-SOMA, RTOG/CTCAE grades, IBDQ, symptom improvement evaluation Month 3: Above + sigmoidoscopy with Vienna scoring Every 6 months after month 6: sigmoidoscopy + all scales + physician's global assessment of treatment efficacy
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
65
Dosage: 50 mL per administration, once daily Duration: 3-6 months of continuous therapy Procedure: Enema depth determined by colonoscopy-identified lesion location Administered as retention enema (minimum 30-minute retention time)
Peking Union Medical College Hospital & Chinese Academy of Medical Sciences
Beijing, Beijing Municipality, China
Change in LENT-SOMA rectal radiation injury scores from baseline to 3 months post-treatment
Treatment response is defined as: 1. Effective: Decrease in LENT-SOMA score compared to baseline 2. Ineffective: No change or increase in LENT-SOMA score versus baseline
Time frame: From enrolment to 3 months post-treatment
Change in Vienna endoscopic scores from baseline to post-treatment
Treatment response is defined as: 1. Effective: Any decrease in Vienna endoscopic score at 3 months post-treatment compared to baseline 2. Ineffective: Stable or increased score compared to baseline
Time frame: From enrolment to 3 months post-treatment
Changes in RTOG and CTCAE grading from baseline to post-treatment assessments
Treatment response is defined as: 1. Efficient: Any decrease in either RTOG radiation toxicity grade or CTCAE adverse event grade from baseline 2. Inefficient: No improvement or worsening in both grading systems
Time frame: From enrolment to 3 months post-treatment
Change in Inflammatory Bowel Disease Questionnaire (IBDQ) Bowel Function and Bleeding Scores from baseline to post-treatment
Treatment response is defined as: 1. Efficient: Any decrease in IBDQ bowel function and bleeding scores post-treatment compared to baseline 2. Inefficient: No change or increase in IBDQ bowel function and bleeding scores versus baseline
Time frame: From enrolment to 3 months post-treatment
Post-treatment symptom improvement rate
Symptoms are categorized into: Complete remission: Complete resolution of clinical symptoms (e.g., rectal bleeding, diarrhea, tenesmus) Partial remission: Significant improvement in symptoms, but not complete resolution Stable disease: No significant change in symptoms (no improvement or worsening) Progression: Worsening of clinical symptoms Treatment response is defined as: 1. Effective: Complete remission or partial remission 2. Ineffective: Stable disease or progression
Time frame: From enrolment to 3 months post-treatment
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.