Treatment of hemorrhagic radiation-induced proctopathy with a 4% formalin application under perianal anesthetic infiltration.
OBJECTIVE
To evaluate the results of hemorrhagic radiation proctopathy treatment with a 4% formalin application.


METHODS
A prospective study was performed. Over a three-year period, 38 patients underwent 4% formalin application under perianal anesthetic infiltration for hemorrhagic radiation proctopathy. All patients included in the study were irradiated for prostate cancer. The patients ranged in age from 56-77 years (average 70 ± 5 years). All of the patients were referred for formalin therapy after noninvasive management had failed. Twenty-four (63.2%) patients underwent a single application, 10 (26.3%) patients underwent 2 applications, and 4 (10.5%) patients underwent 3 applications.


RESULTS
Two to 36 mo (average 12 ± 3 mo) following treatment, 34 patients were interviewed (four were lost to follow-up). Twenty (58.8%) subjects reported complete cure, 8 (23.5%) subjects reported significant improvement, and 6 (17.7%) subjects reported no change. One patient (who underwent a colostomy at a regional hospital with no specialized services available for previous bleeding episodes from radiation proctopathy) was cured, and the colostomy was closed. One patient (2.6%) developed rectal mucosal damage after the second application.


CONCLUSIONS
A 4-min application of 4% formalin for hemorrhagic radiation-induced proctopathy under perianal anesthetic infiltration in patients who have received external radial radiation therapy for prostate cancer is simple, reasonably safe, inexpensive, generally well tolerated, and effective.
Center of Oncosurgery, Institute of Oncology, Clinic of Internal Diseases, Family Medicine and Oncology of Medical Faculty, Vilnius University, LT-08406, Vilnius, Lithuania.
Narimantas Evaldas
NE
Samalavicius
Audrius
A
Dulskas
Alfredas
A
Kilius
Kestutis
K
Petrulis
Darius
D
Norkus
Arvydas
A
Burneckis
Konstantinas Povilas
KP
Valuckas
D000285:Administration, Rectal; D000368:Aged; D000772:Anesthesia, Local; D004334:Drug Administration Schedule; D005557:Formaldehyde / Q000008:administration & dosage* / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006489:Hemostatic Techniques / Q000009:adverse effects; D006490:Hemostatics / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000188:drug therapy* / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D012002:Rectal Diseases / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
D006490:Hemostatics; D005557:Formaldehyde
Formalin application; Prostate cancer; Radiation proctopathy; Rectal bleeding