Article

Effectiveness of argon plasma coagulation in the treatment of chronic actinic proctitis

Service of Radiotherapic Oncology, San Juan Hospital, San Juan de Alicante, Alicante, Spain.
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva (Impact Factor: 1.65). 03/2009; 101(2):91-3, 94-6. DOI: 10.4321/S1130-01082009000200002
Source: PubMed

ABSTRACT There are two kinds of actinic proctitis--one is acute and self-limited, and lasts about 3 months; the other is chronic and develops months to years after radiation therapy. The incidence of chronic actinic proctitis is about 5-20% of radiated prostate tumors.
To evaluate the effectiveness of argon plasma coagulation in the treatment of chronic actinic proctitis.
A retrospective search of patients with the diagnosis of actinic proctitis. The number of argon plasma coagulation therapies needed to achieve the symptom resolution was analyzed.
We found 22 patients with a diagnosis of actinic proctitis. Nineteen were males (86.7%) and three (13.6%) were females. Nineteen patients (86.4%) had a diagnosis of prostate adenocarcinoma, one had a diagnosis of squamous-cell cervix carcinoma (4.5%), and two had a diagnosis of endometrial carcinoma (9.1%). The mean number of coagulation sessions needed for symptom resolution was 2.58 (absolute range 1-7) with a median of 2 sessions.
Multiple treatments are described in the literature. None of them have shown promising results. Our results suggest that argon plasma coagulation is effective in the treatment of this condition, and achieves a rapid and sustained response with few sessions and a good safety profile.

0 Bookmarks
 · 
194 Views
  • Source
    Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 03/2009; 101(2):83-6, 87-90. · 1.65 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic radiation proctopathy occurs in 5%-20% of patients following pelvic radiotherapy. Although many cases resolve spontaneously, some lead to chronic symptoms including diarrhea, tenesmus, urgency and persistent rectal bleeding with iron deficiency anemia requiring blood transfusions. Treatments for chronic radiation proctitis remain unsatisfactory and the basis of evidence for various therapies is generally insufficient. There are very few controlled or prospective trials, and comparisons between therapies are limited because of different evaluation methods. Medical treatments, including formalin, topical sucralfate, 5-amino salicylic acid enemas, and short chain fatty acids have been used with limited success. Surgical management is associated with high morbidity and mortality. Endoscopic therapy using modalities such as the heater probe, neodymium:yttrium-aluminium-garnet laser, potassium titanyl phosphate laser and bipolar electrocoagulation has been reported to be of some benefit, but with frequent complications. Argon plasma coagulation is touted to be the preferred endoscopic therapy due to its efficacy and safety profile. Newer methods of endoscopic ablation such as radiofrequency ablation and cryotherapy have been recently described which may afford broader areas of treatment per application, with lower rate of complications. This review will focus on endoscopic ablation therapies, including such newer modalities, for chronic radiation proctitis.
    World Journal of Gastroenterology 11/2011; 17(41):4554-62. · 2.55 Impact Factor

Full-text

Download
86 Downloads
Available from
May 27, 2014