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Background  Acute radiation-induced proctitis (ARP) is the most common side effect following radiotherapy for malignant pelvic disease. This study evaluated the efficacy of  Aloe vera  ointment in prevention of ARP.    Methods  Forty-two patients receiving external-beam radiotherapy (RT) for pelvic malignancies were randomized to receive either  Aloe vera  3% or placebo topical ointment during radiotherapy for 6 weeks. These patients were evaluated based on the severity (grade 0–4) of the following symptoms weekly: rectal bleeding, abdominal/rectal pain, diarrhea, or fecal urgency. RTOG acute toxicity criteria and psychosocial status of the patients were also recorded weekly. Lifestyle impact of the symptoms, and quantitative measurement of C-reactive protein (CRP), an indicator of systemic inflammation, were also measured.    Results  The results of present study demonstrated a significant preventive effect for  Aloe vera  in occurrence of symptom index for diarrhea ( p  < 0.001), rectal bleeding (p < 0.001), and fecal urgency ( p  = 0.001). The median lifestyle score improved significantly with  Aloe vera  during RT (p < 0.001). Intervention patients had a significant lower burden of systemic inflammation as the values for quantitative CRP decreased significantly over 6 weeks of follow-up ( p  = 0.009).    Conclusion  This study showed that  Aloe vera  topical ointment was effective in prevention of symptoms of ARP in patients undergoing RT for pelvic cancers.    Trial registration   IRCT201606042027N6 . Registration date: 2016-09-04.

bmc complementary medicine and therapies

Prevention of acute radiation-induced Proctitis by Aloe vera: a prospective randomized, double-blind, placebo controlled clinical trial in Pelvic Cancer patients