title: Argon plasma coagulation and hyperbaric oxygen therapy in chronic radiation proctopathy, effectiveness and impact on tissue toxicity.
abstract: BACKGROUND
  chronic radiation proctopathy (CRP) is associated with recurrent rectal bleeding and transfusional requirements. Argon plasma coagulation (APC) and hyperbaric oxygen therapy (HOT) have been shown to be effective in the control of CRP. No prospective comparisons have been reported between these treatments.
  
  
  OBJECTIVE
  the aim was to evaluate the effectiveness, safety and impact on tissue toxicity of APC compared to HOT in patients with CRP.
  
  
  METHODS
  a prospective study for evaluating treatment response was conducted. Patients with cervical cancer and CRP with rectal bleeding were recruited. They had not received previous treatment. Collected data included: demographics, previous radiation dosage, duration and severity of rectal bleeding. Hemoglobin, transfusional requirements, and tissue toxicity (SOMA LENT questionnaire) at baseline and at 1, 2, and 3 months follow up were recorded.
  
  
  RESULTS
  thirty-one patients were included, 14 in the APC group and 17 in the HOT group. No response was noted in 13 and 18% of patients in the APC and HOT group respectively (p = NS). At the 1 and 2 months follow-up, the APC group showed a significantly better response in terms of transfusional requirements (0.6 vs. 3.4 and 0.7 vs. 2.5) and tissue toxicity score (5.3 vs. 8.6 and 3.8 vs. 7.248). After 3 months, both groups showed further improvement in all parameters without significant differences between them.
  
  
  CONCLUSIONS
  APC and HOT were effective, safe and decreased the tissue toxicity scores in patients with CRP. However, response rate was higher and faster in the APC group.
authors.affiliation: Department of Digestive Endoscopy, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico. jc_alvarov@hotmail.com
authors.forename: Julio César
authors.initials: JC
authors.lastname: Alvaro-Villegas
authors.forename: Sergio
authors.initials: S
authors.lastname: Sobrino-Cossío
authors.forename: Luisa Catalina
authors.initials: LC
authors.lastname: Tenorio-Téllez
authors.forename: José Guillermo
authors.initials: JG
authors.lastname: de la Mora-Levy
authors.forename: Angélica
authors.initials: A
authors.lastname: Hernández-Guerrero
authors.forename: Juan Octavio
authors.initials: JO
authors.lastname: Alonso-Lárraga
authors.forename: Teresa
authors.initials: T
authors.lastname: Vela-Chávez
mesh_terms: D057908:Argon Plasma Coagulation; D002908:Chronic Disease; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000473:pathology / Q000628:therapy*; D012002:Rectal Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000532:radiotherapy