Argon plasma coagulation in the treatment of post-radiotherapy rectal bleeding

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Abstract

Introduction: Chronic radiation proctitis is often associated to radiotherapy for treatment of pelvic cancer. The most common side effect of this pathological condition is rectal bleeding but despite the great number of clinical approaches and techniques that have been employed no consensus for the management of it is available. Although prospective randomized trials about hemorrhagic radiation proctitis are still lacking, endoscopic approach delivering an Argon Plasma Coagulation (APC) seems to be a successful and available option. Patients and Methods: Sixteen patients suffering from post-radiotherapy rectalbleeding were followed. In the nine casespresenting a rectum ulcerative colitis (RUC) like endoscopic picture a 5-ASA therapeuticapproach was chosen initially, followed by an APC treatment of areas of telangectasias. The other cases, presenting only areas of telangectasias, were treated only with APC. Results: 5-ASA therapy led to an improvement of inflammation state related to RUC but recurrence of rectal bleeding caused by telangectasias was observed. In these cases an additional APC treatment gave a total remission of the problem. Also in the other cases, presenting only areas of telangectasias, a remission of rectal bleeding was achieved through APC application. Conclusions: In the cases of radiation proctitis characterized by a severe compromission of rectal mucosa integrity an anti-inflammatory pharmacological therapy is necessary but not sufficient to abrogaterectal bleeding which is often caused by thepresence of areas of telangectasias. In these cases a remission of the problem could be achieved through a combination of anti-inflammatory therapy (5-ASA) and APC.
Original languageEnglish
Pages (from-to)37-41
Number of pages5
JournalEuropean Journal of Oncology
Volume17
Publication statusPublished - 2012

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Argon Plasma Coagulation
Radiotherapy
Hemorrhage
Proctitis
Radiation
Ulcerative Colitis
Rectum
Anti-Inflammatory Agents
Therapeutics
Pelvic Neoplasms
Mucous Membrane
Pharmacology
Inflammation
Recurrence

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

@article{46e516dbc06247188c76b6ecf21df94a,
title = "Argon plasma coagulation in the treatment of post-radiotherapy rectal bleeding",
abstract = "Introduction: Chronic radiation proctitis is often associated to radiotherapy for treatment of pelvic cancer. The most common side effect of this pathological condition is rectal bleeding but despite the great number of clinical approaches and techniques that have been employed no consensus for the management of it is available. Although prospective randomized trials about hemorrhagic radiation proctitis are still lacking, endoscopic approach delivering an Argon Plasma Coagulation (APC) seems to be a successful and available option. Patients and Methods: Sixteen patients suffering from post-radiotherapy rectalbleeding were followed. In the nine casespresenting a rectum ulcerative colitis (RUC) like endoscopic picture a 5-ASA therapeuticapproach was chosen initially, followed by an APC treatment of areas of telangectasias. The other cases, presenting only areas of telangectasias, were treated only with APC. Results: 5-ASA therapy led to an improvement of inflammation state related to RUC but recurrence of rectal bleeding caused by telangectasias was observed. In these cases an additional APC treatment gave a total remission of the problem. Also in the other cases, presenting only areas of telangectasias, a remission of rectal bleeding was achieved through APC application. Conclusions: In the cases of radiation proctitis characterized by a severe compromission of rectal mucosa integrity an anti-inflammatory pharmacological therapy is necessary but not sufficient to abrogaterectal bleeding which is often caused by thepresence of areas of telangectasias. In these cases a remission of the problem could be achieved through a combination of anti-inflammatory therapy (5-ASA) and APC.",
author = "{Lo Monte}, {Attilio Ignazio} and Salvatore Buscemi and Palumbo, {Vincenzo Davide} and Giuseppe Damiano and Giovanni Tomasello and Giuseppe Buscemi and Francesco Damiani and Giuseppe Buscemi and Salvatore Buscemi and Gabriele Spinelli and {Di Ganci}, Simona",
year = "2012",
language = "English",
volume = "17",
pages = "37--41",
journal = "European Journal of Oncology",
issn = "1128-6598",
publisher = "Mattioli 1885 S.p.A.",

}

TY - JOUR

T1 - Argon plasma coagulation in the treatment of post-radiotherapy rectal bleeding

AU - Lo Monte, Attilio Ignazio

AU - Buscemi, Salvatore

AU - Palumbo, Vincenzo Davide

AU - Damiano, Giuseppe

AU - Tomasello, Giovanni

AU - Buscemi, Giuseppe

AU - Damiani, Francesco

AU - Buscemi, Giuseppe

AU - Buscemi, Salvatore

AU - Spinelli, Gabriele

AU - Di Ganci, Simona

PY - 2012

Y1 - 2012

N2 - Introduction: Chronic radiation proctitis is often associated to radiotherapy for treatment of pelvic cancer. The most common side effect of this pathological condition is rectal bleeding but despite the great number of clinical approaches and techniques that have been employed no consensus for the management of it is available. Although prospective randomized trials about hemorrhagic radiation proctitis are still lacking, endoscopic approach delivering an Argon Plasma Coagulation (APC) seems to be a successful and available option. Patients and Methods: Sixteen patients suffering from post-radiotherapy rectalbleeding were followed. In the nine casespresenting a rectum ulcerative colitis (RUC) like endoscopic picture a 5-ASA therapeuticapproach was chosen initially, followed by an APC treatment of areas of telangectasias. The other cases, presenting only areas of telangectasias, were treated only with APC. Results: 5-ASA therapy led to an improvement of inflammation state related to RUC but recurrence of rectal bleeding caused by telangectasias was observed. In these cases an additional APC treatment gave a total remission of the problem. Also in the other cases, presenting only areas of telangectasias, a remission of rectal bleeding was achieved through APC application. Conclusions: In the cases of radiation proctitis characterized by a severe compromission of rectal mucosa integrity an anti-inflammatory pharmacological therapy is necessary but not sufficient to abrogaterectal bleeding which is often caused by thepresence of areas of telangectasias. In these cases a remission of the problem could be achieved through a combination of anti-inflammatory therapy (5-ASA) and APC.

AB - Introduction: Chronic radiation proctitis is often associated to radiotherapy for treatment of pelvic cancer. The most common side effect of this pathological condition is rectal bleeding but despite the great number of clinical approaches and techniques that have been employed no consensus for the management of it is available. Although prospective randomized trials about hemorrhagic radiation proctitis are still lacking, endoscopic approach delivering an Argon Plasma Coagulation (APC) seems to be a successful and available option. Patients and Methods: Sixteen patients suffering from post-radiotherapy rectalbleeding were followed. In the nine casespresenting a rectum ulcerative colitis (RUC) like endoscopic picture a 5-ASA therapeuticapproach was chosen initially, followed by an APC treatment of areas of telangectasias. The other cases, presenting only areas of telangectasias, were treated only with APC. Results: 5-ASA therapy led to an improvement of inflammation state related to RUC but recurrence of rectal bleeding caused by telangectasias was observed. In these cases an additional APC treatment gave a total remission of the problem. Also in the other cases, presenting only areas of telangectasias, a remission of rectal bleeding was achieved through APC application. Conclusions: In the cases of radiation proctitis characterized by a severe compromission of rectal mucosa integrity an anti-inflammatory pharmacological therapy is necessary but not sufficient to abrogaterectal bleeding which is often caused by thepresence of areas of telangectasias. In these cases a remission of the problem could be achieved through a combination of anti-inflammatory therapy (5-ASA) and APC.

UR - http://hdl.handle.net/10447/71063

M3 - Article

VL - 17

SP - 37

EP - 41

JO - European Journal of Oncology

JF - European Journal of Oncology

SN - 1128-6598

ER -