Argon plasma coagulation as first-line treatment for chronic radiation proctopathy.
OBJECTIVE
Chronic radiation proctopathy is a troublesome complication of radiotherapy to the pelvis, for which current treatment modalities are unsatisfactory. The present prospective study was designed to determine the usefulness and safety of argon plasma coagulation in the management of chronic radiation proctopathy.


METHODS
Twenty-five consecutive patients (M:F 24:1, mean age: 69 years) with radiation proctopathy were prospectively included. All patients received argon plasma coagulation by a standard protocol. Response to treatment was assessed by symptom response, bleeding severity score, hematological parameters and transfusion requirements over a median 14-month follow up.


RESULTS
Patients received a median of one treatment session with argon plasma coagulation. There was significant improvement in rectal bleeding in all patients, with complete cessation of bleeding in 21 (81%) of the patients. The median bleeding severity score fell from 3 to 0 (P < 0.0005). The mean hemoglobin level rose from 10.05 +/- 2.21 g/dL before treatment to 12.44 +/- 1.09 g/dL at 6 months following treatment (P < 0.002). There was also improvement in other symptoms such as urgency and diarrhea. Over the period of follow up, there was no recurrence of anemia and no complications were noted.


CONCLUSIONS
These results suggest that argon plasma coagulation is a safe and effective modality in the treatment of chronic radiation proctopathy.
Sebastian
Shaji
S
Department of Gastroenterology, Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Ireland. sebastianshaji@eircom.net
O'Connor
Humphrey
H
O'Morain
Colm
C
Buckley
Martin
M
D000368:Aged; D001128:Argon / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D005741:Noble Gases / Q000627:therapeutic use; D011349:Proctitis / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
D005741:Noble Gases; D001128:Argon