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https://hdl.handle.net/2440/82676
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Type: | Journal article |
Title: | Argon plasma coagulation therapy versus topical formalin for intractable rectal bleeding and anorectal dysfunction after radiation therapy for prostate carcinoma |
Author: | Yeoh, E. Tam, W. Schoeman, M. Moore, J. Thomas, M. Botten, R. Di Matteo, A. |
Citation: | International Journal of Radiation: Oncology - Biology - Physics, 2013; 87(5):954-959 |
Publisher: | Elsevier Science Inc |
Issue Date: | 2013 |
ISSN: | 0360-3016 1879-355X |
Statement of Responsibility: | Eric Yeoh, William Tam, Mark Schoeman, James Moore, Michelle Thomas, Rochelle Botten, and Addolorata Di Matteo |
Abstract: | <h4>Purpose</h4>To evaluate and compare the effect of argon plasma coagulation (APC) and topical formalin for intractable rectal bleeding and anorectal dysfunction associated with chronic radiation proctitis.<h4>Methods and materials</h4>Thirty men (median age, 72 years; range, 49-87 years) with intractable rectal bleeding (defined as ≥1× per week and/or requiring blood transfusions) after radiation therapy for prostate carcinoma were randomized to treatment with APC (n=17) or topical formalin (n=13). Each patient underwent evaluations of (1) anorectal symptoms (validated questionnaires, including modified Late Effects in Normal Tissues-Subjective, Objective, Management, and Analytic and visual analogue scales for rectal bleeding); (2) anorectal motor and sensory function (manometry and graded rectal balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before and after the treatment endpoint (defined as reduction in rectal bleeding to 1× per month or better, reduction in visual analogue scales to ≤25 mm, and no longer needing blood transfusions).<h4>Results</h4>The treatment endpoint was achieved in 94% of the APC group and 100% of the topical formalin group after a median (range) of 2 (1-5) sessions of either treatment. After a follow-up duration of 111 (29-170) months, only 1 patient in each group needed further treatment. Reductions in rectal compliance and volumes of sensory perception occurred after APC, but no effect on anorectal symptoms other than rectal bleeding was observed. There were no differences between APC and topical formalin for anorectal symptoms and function, nor for anal sphincteric morphology.<h4>Conclusions</h4>Argon plasma coagulation and topical formalin had comparable efficacy in the durable control of rectal bleeding associated with chronic radiation proctitis but had no beneficial effect on anorectal dysfunction. |
Keywords: | Rectum Humans Prostatic Neoplasms Proctitis Radiation Injuries Gastrointestinal Hemorrhage Formaldehyde Coagulants Administration, Topical Sensation Aged Aged, 80 and over Middle Aged Anal Canal Male Argon Plasma Coagulation |
Rights: | © 2013 Elsevier Inc. All rights reserved |
DOI: | 10.1016/j.ijrobp.2013.08.034 |
Published version: | http://dx.doi.org/10.1016/j.ijrobp.2013.08.034 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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