Prevention and Management of Radiation-induced Late Gastrointestinal Toxicity

In the UK, about 90000 cancer survivors will suffer from pelvic radiation disease (PRD) due to their curative treatment including radiotherapy. The National Cancer Survivorship Initiative aims to improve the understanding and management of PRD by the oncology community. This overview covers the prevention, investigation and treatment for late radiation-induced gastrointestinal symptoms in PRD. Multiple pharmacological and nutritional interventions have been studied, as prophylaxis for acute gastrointestinal toxicity (aiming to prevent late consequential effects), although predominantly only small randomised controlled trials have been conducted. These have produced mixed results, although promising signals for some agents have been observed. Evidence for the pharmacological prevention of late gastrointestinal toxicity is scarce. Even fewer randomised controlled trials have investigated the late gastrointestinal toxicity profile of advanced radiotherapy technologies. There are nationally agreed algorithms for the investigation and management of PRD, but a lack of awareness means patients still do not get referred appropriately. This overview outlines the management of radiation proctopathy and diarrhoea, and signposts other accessible resources. Finally, we provide recommendations for the management of late gastrointestinal symptoms in PRD and research in this field, especially the need for high-quality clinical trials

Evolution of genes and genomes on the Drosophila phylogeny

Comparative analysis of multiple genomes in a phylogenetic framework dramatically improves the precision and sensitivity of evolutionary inference, producing more robust results than single-genome analyses can provide. The genomes of 12 Drosophila species, ten of which are presented here for the first time (sechellia, simulans, yakuba, erecta, ananassae, persimilis, willistoni, mojavensis, virilis and grimshawi), illustrate how rates and patterns of sequence divergence across taxa can illuminate evolutionary processes on a genomic scale. These genome sequences augment the formidable genetic tools that have made Drosophila melanogaster a pre-eminent model for animal genetics, and will further catalyse fundamental research on mechanisms of development, cell biology, genetics, disease, neurobiology, behaviour, physiology and evolution. Despite remarkable similarities among these Drosophila species, we identified many putatively non-neutral changes in protein-coding genes, non-coding RNA genes, and cis-regulatory regions. These may prove to underlie differences in the ecology and behaviour of these diverse species