Application of Formaldehyde for Treatment of Hemorrhagic Radiation‐Induced Proctitis

Roche, Bruno; Chautems, Roland; Marti, M.-C.

doi:10.1007/s002689900166

Cited by 64 publications

(46 citation statements)

References 20 publications

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“…11,64 In several small, nonrandomized studies, the short-term success rate of this technique ranged from 60% to 100%. [66][67][68][69][70][71][72][73] The documented complications, including perianal ulcerations and fissures, anal stenosis, and fecal incontinence, occurred in 27% of patients.…”

Section: Topical Formalinmentioning

confidence: 99%

Late rectal complications after prostate brachytherapy for localized prostate cancer

Phan¹,

Swanson²,

Levy³

et al. 2009

Cancer

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This review of the literature on late rectal complications after prostate brachytherapy indicated that it is a highly effective treatment modality for patients with clinically localized prostate cancer but can cause chronic radiation proctitis. The most common manifestation of chronic radiation proctitis was anterior rectal wall bleeding, which often occurred within the first 2 years after brachytherapy. It is interesting to note that the rates of late rectal morbidity appear to have declined over time, which may reflect improvements in implantation techniques and imaging. Rectal biopsy as part of the workup to evaluate rectal bleeding can lead to rectal fistula and the need for colostomy, a rare but major complication. The authors recommend 1) screening colonoscopy before brachytherapy for patients who have not had a screening colonoscopy within the preceding 3 years to rule out colorectal malignancies and, thus, facilitate conservative management should rectal bleeding occur; 2) lifestyle modifications during treatment to limit exposure of the rectum to radiation; and 3) conservative management for rectal bleeding that occurs within 2 years after brachytherapy. Prostate cancer is the leading cause of cancer in men and accounts for approximately 33% of cancer deaths among men in the US.1,2 Management options for organ-confined, low-to intermediate-risk prostate cancer include watchful waiting, radical prostatectomy, external-beam radiation therapy, and prostate brachytherapy with permanent interstitial implants. Recent improvements in radioactive seed implantation techniques have established prostate brachytherapy as a highly effective treatment modality for localized prostate cancer, with long-term local and biochemical control similar to outcomes observed after radical prostatectomy and external-beam radiation therapy. 3,4 Because prostate cancer is diagnosed

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Section: Topical Formalinmentioning

confidence: 99%

Late rectal complications after prostate brachytherapy for localized prostate cancer

Phan¹,

Swanson²,

Levy³

et al. 2009

Cancer

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“…Local application of 4% formaldehyde has been used with greater therapeutic success in some studies (Table 2). 12,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] Evidence suggests that formalin is very effective in the treatment of CHRP, mainly in patients in whom the distal third of the rectum is affected. Other advantages of formalin application are low cost, low incidence of side-effects, ready availability, and easy application.…”

Section: Formalinmentioning

confidence: 99%

“…11 It occurs among 5-20% of patients in the form of bleeding, fistula, ulceration and strictures. 12 It presents as rectal bleeding, diarrhea, mucus discharge, tenesmus, incontinence and urgency. In an assessment of 90 patients with radiation damage to the rectosigmoid, den Hartog Jager et al found that rectal bleeding was the main presenting complaint in up to 72% of patients.…”

Section: Introductionmentioning

confidence: 99%

Management of chronic hemorrhagic radiation proctitis

Agrawal

Bansal

Bahadur

et al. 2007

Asia-Pac J Clncl Oncology

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Rectal bleeding secondary to radiation proctitis is the most dreaded complication of pelvic radiotherapy. Its management remains a perplexing problem despite the availability of multiple treatment modalities. Patients are usually managed on a "hit and miss" basis at most centers. Steroid, 5-aminosalicylic acid, short chain fatty acids and sucralfate enemas, hyperbaric oxygen therapy, and topical application of 4% formaldehyde all have been used with varying results. Surgical procedures such diversion colostomy or resection of involved segment have been proposed for refractory bleeding. Endoscopic methods are being increasingly adopted in the form of bipolar electrocoagulation, heat probe coagulation, photoablation, Nd:YAG laser and preferably argon plasma coagulation. The utility of conservative approaches remains far below desirable levels. Onset of hemorrhagic recurrence represents a major obstacle that leads to a need for repeated therapeutic sessions and sometimes invocation of radical techniques. This review discusses various treatment modalities and aims to identify their efficacy and limitations. A critical review was conducted of published reports regarding management of chronic hemorrhagic radiation proctitis (CHRP). Although there are few prospective randomized trials, enough evidence is available to conclude that argon plasma coagulation represents the current treatment of choice.

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“…Silver nitrate, an inorganic silver salt, induces a chemical cauterization and has been used to control bladder hemorrhages and epistaxis [12,23]. Formalin, 2% or 4%, acts as a chemical cautery and has been used to control intractable rectal [24][25][26] and bladder [22] hemorrhaging. In one case series, topical formalin controlled bleeding in 49 of 55 patients (89%) with radiationinduced rectal bleeding.…”

Section: Etiology and Clinical Presentationmentioning

confidence: 99%

Management of Bleeding in Patients with Advanced Cancer

2004

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Bleeding occurs in up to 10% of patients with advanced cancer. It can present in many different ways. This article provides a qualitative review of treatment options available to manage visible bleeding. Local modalities, such as hemostatic agents and dressings, radiotherapy, endoscopic ligation and coagulation, and transcutaneous arterial embolization, are reviewed in the context of advanced cancer, as are systemic treatments such as vitamin K, vasopressin/desmopressin, octreotide/somatostatin, antifibrinolytic agents (tranexamic acid and aminocaproic acid), and blood products. Considerations at the end of life are described.

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Application of Formaldehyde for Treatment of Hemorrhagic Radiation‐Induced Proctitis

Cited by 64 publications

References 20 publications

Late rectal complications after prostate brachytherapy for localized prostate cancer

Late rectal complications after prostate brachytherapy for localized prostate cancer

Management of chronic hemorrhagic radiation proctitis

Management of Bleeding in Patients with Advanced Cancer

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