Argon plasma coagulation and hyperbaric oxygen therapy in chronic radiation proctopathy, effectiveness and impact on tissue toxicity

• Published in: Revista española de enfermedades digestivas Vol. 103; no. 11; pp. 576 - 581
• Main Authors: Alvaro-Villegas, Julio César, Sobrino-Cossío, Sergio, Tenorio-Téllez, Luisa Catalina, de la Mora-Levy, José Guillermo, Hernández-Guerrero, Angélica, Alonso-Lárraga, Juan Octavio, Vela-Chávez, Teresa
• Format: Journal Article
• Language: English; Spanish; Portuguese
• Published: Spain Sociedad Española de Patología Digestiva 01.11.2011
• Subjects: Argon Plasma Coagulation; Chronic Disease; Female; Gastroenterology & Hepatology; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - pathology; Gastrointestinal Hemorrhage - therapy; Geriatrics & Gerontology; Humans; Hyperbaric Oxygenation; Infectious Diseases; Middle Aged; Oncology; Pathology; Pharmacology & Pharmacy; Prospective Studies; Radiation Injuries - pathology; Radiation Injuries - therapy; Radiology, Nuclear Medicine & Medical Imaging; Rectal Diseases - etiology; Rectal Diseases - pathology; Rectal Diseases - therapy; Surgery; Treatment Outcome; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - radiotherapy
• ISSN: 1130-0108
• DOI: 10.4321/S1130-01082011001100004

chronic radiation proctopathy (CRP) is associated with recurrent rectal bleeding and transfusional requirements. Argon plasma coagulation (APC) and hyperbaric oxygen therapy (HOT) have been shown to be effective in the control of CRP. No prospective comparisons have been reported between these treatments. the aim was to evaluate the effectiveness, safety and impact on tissue toxicity of APC compared to HOT in patients with CRP. a prospective study for evaluating treatment response was conducted. Patients with cervical cancer and CRP with rectal bleeding were recruited. They had not received previous treatment. Collected data included: demographics, previous radiation dosage, duration and severity of rectal bleeding. Hemoglobin, transfusional requirements, and tissue toxicity (SOMA LENT questionnaire) at baseline and at 1, 2, and 3 months follow up were recorded. thirty-one patients were included, 14 in the APC group and 17 in the HOT group. No response was noted in 13 and 18% of patients in the APC and HOT group respectively (p = NS). At the 1 and 2 months follow-up, the APC group showed a significantly better response in terms of transfusional requirements (0.6 vs. 3.4 and 0.7 vs. 2.5) and tissue toxicity score (5.3 vs. 8.6 and 3.8 vs. 7.248). After 3 months, both groups showed further improvement in all parameters without significant differences between them. APC and HOT were effective, safe and decreased the tissue toxicity scores in patients with CRP. However, response rate was higher and faster in the APC group.