Year 2019 / Volume 111 / Number 11
Original
Short and long term response to argon plasma therapy for hemorrhagic radiation proctitis

852-857

DOI: 10.17235/reed.2019.5998/2018

Elizabeth Montes de Oca Megías, Maricela Morera Pérez, Guillermo Noa Pedroso, Felipe Piñol Jiménez, Mildred Armenteros Torres,

Abstract
Introduction: hemorrhagic radiation proctitis appears secondary to radiotherapy. Argon plasma is an effective, safe and easy-to-use technique with a relatively low cost. Objectives: to describe the short- and long-term response to argon plasma therapy in patients with hemorrhagic radiation proctitis. Method: an observational prospective study was performed of a series of 82 patients with hemorrhagic radiation proctitis, attended at the National Center for Minimally Invasive Surgery between 2010 and 2016. Summary measurements and a comparison of means (paired Student’s t-test) for the final and initial hemoglobin levels were used. In addition, the Kaplan-Meier method was used to determine the rectal bleeding recurrence free time. Results: in the present study, 54.9% of cases required 1-3 argon sessions and 86.6% required 1-5 sessions to resolve the bleeding, with a median of 3.0 sessions. In addition, 4.9% of patients had proctalgia as a complication. There was an improvement in hemoglobin of 2 g/dl. Rectal bleeding recurrence occurred in 8.5% of the patients during the nine months after therapy. Bleeding recurrence free time at three, six and nine months was 98.8%, 96.3% and 91.5%, respectively. Short-term therapy response was observed in all patients and long-term response after one year of follow-up was 91.5%. Conclusion: argon plasma coagulation shows a good short- and long-term response with few therapy sessions and a low rate of complications in patients with chronic hemorrhagic radiation proctitis.
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References
1. Peng Y, Wang H, Feng J, et al. Efficacy and Safety of Argon Plasma Coagulation for Hemorrhagic Chronic Radiation Proctopathy: A Systematic Review. Gastroenterology Research and Practice [Internet]. 2018 (Cited Jun 4th, 2018). Available from꞉ https://doi.org/10.1155/2018/3087603
2. Karamanolis G, Psatha P, Triantafyllou K. Endoscopic treatment for chronic radiation proctitis. World J Gastrointest Endosc 2013; 5(7):308-12.
3. Phan J, Swanson DA, Levy LB, et al. Late rectal complications after prostate brachytherapy for localized prostate cancer. Cancer 2009; 115:1827–39.
4. Denton AS, Andreyev JJ, Forbes A, et al. Non surgical interventions for late radiation proctitis in patients who have received radical radiotherapy to the pelvis. Cochrane Database of Systematic Reviews [Internet]. 2002 [cited Jan 7th, 2018], Issue 1. Art. No.: CD003455. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11869662.1, https://doi.org/10.1002/14651858.CD003455
5. Álvaro-Villegas JC, Sobrino-Cossio S, Tenorio-Téllez LC, et al. Argon plasma coagulation and hyperbaric oxygen therapy in chronic radiation proctopathy, effectiveness and impact on tissue toxicity. Rev Esp Enferm Dig 2011; 103: 576-581.
6. Rustagi T, Mashimo H. Endoscopic management of chronic radiation proctitis. World J Gastroenterol 2011; 17(41): 4554-4562.
7. Zhou C, Adler DC, Becker L, et al. Effective Treatment of Chronic Radiation Proctitis Using Radiofrequency Ablation. Therap Adv Gastroenterol 2009; 2(3): 149–156.
8. Placer C, Lizarazu A, Borda N, et al. Proctitis actínica hemorraágica crónica y refractaria. Experiencia con formaldehído al 4%. Cir Esp 2013; 91 (2): 111– 114.
9. Moawad FJ, Maydonovitch CL, Horwhat D. Efficacy of cryospray ablation for the treatment of chronic radiation proctitis in a pilot study. Digestive Endoscopy 2013; 25: 174–179.
10. Hanson B, MacDonald R, Shaukat A. Endoscopic and medical therapy for chronic radiation proctopathy: a systematic review. Dis Colon Rectum 2012; 55 (10):1081-95.
11. Gibson RJ, Keefe DM, Lalla R, et al. Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. Support Care Cancer 2013; 21:313–326.
12. Lenz L, Rohr R, Nakao F, et al. Chronic radiation proctopathy: A practical review of endoscopic treatment. World J Gastrointest Surg 2016; 8(2): 151-160.
13. Martínez López R, Díaz-Canel Fernández O, Ruiz Torres J, et al. Tratamiento de la proctitis actinica con argon plasma. Primera experiencia en Cuba. Rev haban cienc méd [Internet]. 2008 [citado 2018 Mar 15]; Vol. VII. No. 1 ene-mar. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1729-519X2008000100020
14. Montes de Oca Megías E, Morera Pérez M, Pedroso Noa G, et al. Endoscopic Therapy with Argon Plasma for Radiation Proctitis: Factors Associated to the Number of Therapeutic Sessions. Gastroenterol Hepatol Open Access [Internet]. 2017 [cited Mar 15th, 2018]; 8(2): 00276. Available from: https://medcraveonline.com/GHOA/GHOA-08-00276.php,
DOI: 10.15406/ghoa.2017.08.00276
15. Chutkan R, Lipp J, Waye J. The argon plasma coagulator: a new and effective modality for treatment of radiation proctitis [abstract]. Gastrointest Endosc [Internet]. 1997 [cited Mar 15th, 2018]; 45:AB27. Available from: https://www.giejournal.org/article/S0016-5107(97)80012-0/abstract.
16. Zinicola R, Rutter MD, Felasco G, et al. Hemorrhagic radiation proctitis: endoscopic severity may be useful it guide therapy. Int J Colorectal Dis 2003; 18: 439-44.
17. Tormo V, Wikman Jorgensen P, García del Castillo G, et al. Efectividad de la fulguración con argón plasma en el tratamiento de la proctitis actínica crónica. Rev. esp. enferm. dig. [Internet]. 2009 Feb [citado 2019 Ene 19] ; 101( 2 ): 91-96. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082009000200002&lng=es.
18. Sebastian S, O'Connor H, O'Morain C, et al. Argon plasma coagulation as first-line treatment for chronic radiation proctopathy. Journal of Gastroenterology and Hepatology 2004; 19(10): 1169–1173.
19. Sait Dag M, Akin D, Abidin Ozturk Z, et al. The Efficacy and Safety of Argon Plasma Coagulation in Treatment of Radiation Proctitis. Biomed Res [Internet]. 2013 [cited Jan 7th, 2018]; 24(1): 36-39. Available from: https://pdfs.semanticscholar.org/f598/76dd2a1fd32cf24f6d3ef460b15d4bfbeb73.pdf
20. Ministerio de Salud Pública (MINSAP) (2018) República de Cuba. Oficina Nacional de Estadísticas (ONE). Anuario Estadístico de Cuba 2017, edición 2018. La Habana. Disponible en: http://files.sld.cu/dne/files/2018/04/Anuario-Electronico-Espa%C3%B1ol-2017-ed-2018.pdf
21. Hortelano E, Gómez-Iturriaga A, Ortiz-de-Zárate R, et al. Is argon plasma coagulation an effective and safe treatment option for patients with chronic radiation proctitis after high doses of radiotherapy? Rev Esp Enferm Dig [Internet]. 2014 [cited Jan 7th, 2018]];106:165-70. Available from: http://www.grupoaran.com/mrmUpdate/lecturaPDFfromXML.asp?IdArt=4620880&TO=RVN&Eng=1
22. Karamanolis G, Triantafyllou K, Tsiamoulos Z et al. Argon plasma coagulation has a long-lasting therapeutic effect in patients with chronic radiation proctitis. Endoscopy 2009; 41(6):529–53.
23. Chruscielewska-Kiliszek MR, Regula J, Polkowski M, et al.“Sucralfate or placebo following argon plasma coagulation for chronic radiation proctitis: a randomized double blind trial”. Colorectal Disease [Internet]. 2013 (Cited Jun 4th, 2018); 15 (1): e48–e55. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/codi.12035, DOI: 10.1111/codi.12035
24. de la Serna Higuera C, Martin Arribas M, Rodriguez Gomez S, et al. Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis. Rev Esp Enferm Dig 2004; 96(11): 758–764.
25. Tagkalidis PP, Tjandra JJ. Chronic radiation proctitis. ANZ J Surg 2001; 71: 230-237.
26. Latorre Sánchez M, Sempere García-Argüelles J, Barceló Cerdá S, et al. Valoración de la respuesta endoscópica al tratamiento con argón plasma en la rectitis actínica crónica. Rev Esp Enferm Dig 2008; 100(10): 619-624.
27. Dees J, Meijssen MA, Kuipers EJ. Argon plasma coagulation for radiation proctitis. Scand J Gastroenterol [Internet]. 2006 (Cited Jun 4th, 2018); Suppl 243: 175-178. Available from: DOI:10.1080/00365520600664300
28. Swan MP, Moore GT, Sievert W, Devonshire DA. Efficacy and safety of single-session argon plasma coagulation in the management of chronic radiation proctitis. Gastrointest Endosc 2010; 72(1):150-4.
29. Tam W, Moore J, Schoeman M. Treatment of radiation proctitis with argon plasma coagulation. Endoscopy 2000; 32 (9): 667–72.
30. Tjandra JJ, Sengupta S. Argon plasma coagulation is an effective treatment for refractory hemorrhagic radiation proctitis. Diseases of the Colon & Rectum 2001; 44 (12):1759–65.
31. Yeoh E, Tam W, Schoeman M, et al. Argon plasma coagulation therapy versus topical formalin for intractable rectal bleeding and anorectal dysfunction after radiation therapy for prostate carcinoma. International Journal of Radiation Oncology, Biology, Physics 2013; 87 (5): 954–9.
32. Villavicencio RT, Rex DK, Rahmani E. Efficacy and complications of argon plasma coagulation for hematochezia related to radiation proctopathy. Gastrointestinal Endoscopy 2002; 55 (1): 70–74.
33. Canard JM, Vedrenne B, Bors G, Claude P, Bader R, Sondag D. Treatment of radiation proctitis by coagulation: long term results.Gastroentérologie Clinique et Biologique [Internet]. 2003 (Cited Jun 4th, 2018); 27 (5): 455–459. Available from: https://www.em-consulte.com/en/article/159056
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Montes de Oca Megías E, Morera Pérez M, Noa Pedroso G, Piñol Jiménez F, Armenteros Torres M. Short and long term response to argon plasma therapy for hemorrhagic radiation proctitis. 5998/2018


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Publication history

Received: 26/10/2018

Accepted: 09/04/2019

Online First: 09/10/2019

Published: 07/11/2019

Article revision time: 161 days

Article Online First time: 348 days

Article editing time: 377 days


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