Argon plasma coagulation as first‐line treatment for chronic radiation proctopathy

Sebastian, Shaji; O'Connor, H.J.; O’Moráin, Colm; Buckley, Martin

doi:10.1111/j.1440-1746.2004.03448.x

Cited by 71 publications

(66 citation statements)

References 24 publications

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“…18 Second, local treatment of rectal bleeding is quite successful, especially with argon plasma coagulation. 19 Prevalence of fecal incontinence after radiation therapy showed evidence of progressive worsening of the anorectal function. Yeoh et al 20 found a decline in rectal compliance and thickening of the external anal sphincter in patients after radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Time course of late rectal toxicity after radiation therapy for prostate cancer

Odrážka

Doležel

Vaňásek³

et al. 2009

Prostate Cancer Prostatic Dis

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Rectum and bladder are the crucial organs at risk for curative radiation therapy of localized prostate cancer. We analyzed the incidence, profile and time course of late rectal radiation toxicity. A total of 320 patients with T1-3 prostate cancer were treated with three-dimensional conformal radiation therapy (3D-CRT). The prescription dose was 70 Gy for T1 and T2 patients (n ¼ 230) and 74 Gy for patients with locally advanced T3 tumors (n ¼ 90). Late rectal toxicity was graded according to the Fox Chase modification of the Radiation Therapy Oncology Group (RTOG) and Late Effects Normal Tissue Task Force (LENT) criteria. The median follow-up time was 6.2 years (range 0.2-10.7 years). At 5 years, the risk for the development of grade 2 and 3 rectal toxicities was 15.6 and 7.0%, respectively. All new cases of grade 2 and 3 rectal toxicities were observed within 5 years after treatment. Prevalence of grade 2 and 3 rectal symptoms showed fluctuation with maximum at 1.5 years and the minor peak at 4.5 years. Toxicity profile changed significantly over time. The proportion of rectal bleeding within grade 2 and 3 toxicity decreased from 85% at 1.5 years to 46% at 4.5 years. Conversely, the proportion of fecal incontinence among grade 2 and 3 rectal symptoms gradually increased (0% at 1.5 years vs 27% at 4.5 years). Late rectal radiation toxicity represents a dynamic process. Rectal bleeding decreases and fecal incontinence increases over time.

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Section: Discussionmentioning

confidence: 99%

Time course of late rectal toxicity after radiation therapy for prostate cancer

Odrážka

Doležel

Vaňásek³

et al. 2009

Prostate Cancer Prostatic Dis

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“…86 In several other studies, cessation of bleeding was reported after 1 to 3 sessions of APC. [87][88][89][90][91][92] Complications of APC include rectal pain, rectal stenosis, altered bowel habits, and rectal wall injury. Reported rates of rectal ulceration leading to fistula development range from <1% to 2%.…”

Section: Argon Plasma Coagulationmentioning

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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“…All patients had rectal bleeding due to CRP (grade 4 in Chutkan scale) (18) and all underwent full colonoscopy examination to rule out other causes of bleeding (i.e. local tumor activity or diverticulosis).…”

Section: Methodsmentioning

confidence: 99%

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

Alvaro-Villegas

Sobrino-Cossío

Tenorio-TéLlez

et al. 2011

Rev. esp. enferm. dig.

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Argon plasma coagulation as first‐line treatment for chronic radiation proctopathy

Abstract: These results suggest that argon plasma coagulation is a safe and effective modality in the treatment of chronic radiation proctopathy.

Cited by 71 publications

References 24 publications

Time course of late rectal toxicity after radiation therapy for prostate cancer

Time course of late rectal toxicity after radiation therapy for prostate cancer

Late rectal complications after prostate brachytherapy for localized prostate cancer

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

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