Thalidomide for refractory hemorrhagic chronic radiation proctitis: Bridging the gap between symptom control and disease-modifying therapy

doi:10.3748/wjg.120289

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Oct 14, 2026; 32(38): 120289
Published online Oct 14, 2026. doi: 10.3748/wjg.120289

Thalidomide for refractory hemorrhagic chronic radiation proctitis: Bridging the gap between symptom control and disease-modifying therapy

Ya Deng, Zhi-Min Du, Hong-Fang Li, Fu-Shan Tang

Ya Deng, Zhi-Min Du, Hong-Fang Li, Fu-Shan Tang, Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, Zunyi 563006, Guizhou Province, China

Ya Deng, Zhi-Min Du, Hong-Fang Li, Fu-Shan Tang, Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, Guizhou Province, China

Hong-Fang Li, Department of Pharmacy, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi 563003, Guizhou Province, China

Author contributions: Deng Y drafted and revised the manuscript; Du ZM and Li HF provided discussion and literature support; Tang FS contributed to idea generation, revised the manuscript, and provided supervision. All authors reviewed and approved the final manuscript.

AI contribution statement: No AI tool was used to generate any part of the main text (Abstract, Introduction, Materials and Methods, Results, Discussion, or Conclusion). The conceptual framework, critical evaluation of Huang et al’s work, analysis of CRP pathophysiology, editorial viewpoints, and all references are entirely our own. However, as non-native English speakers, we used DeepL and ChatGPT only for language polishing and sentence-level revision to improve fluency.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

Corresponding author: Fu-Shan Tang, PhD, Professor, Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, No. 6 Xuefu West Road, Xinpu New District, Zunyi 563006, Guizhou Province, China. fstang@vip.163.com

Received: February 24, 2026
Revised: April 16, 2026
Accepted: May 22, 2026
Published online: October 14, 2026
Processing time: 196 Days and 10.1 Hours

Core Tip

Core Tip: Low-dose thalidomide demonstrated an 83.9% clinical remission rate and favorable safety profile in refractory hemorrhagic chronic radiation proctitis (CRP) during a phase II trial, suggesting its potential as a systemic therapeutic option based on preliminary evidence. The observed discrepancy between symptom improvement and endoscopic findings underscores the necessity of including patient-reported outcomes alongside traditional objective metrics. This article reviews the pathogenesis and treatment options for CRP, interprets thalidomide’s clinical significance, evaluates the limitations of the study, and advocates for mechanism-based comprehensive management strategies during cancer survivorship.