title: The protective role of antiplatelet treatment against ulcer formation due to argon plasma coagulation in patients treated for chronic radiation proctitis.
abstract: OBJECTIVE
  Following treatment with argon plasma coagulation (APC), rectal ulceration is seen in approximately 50% of patients with haemorrhagic chronic radiation proctitis (CRP). This study aimed to assess the frequency of rectal ulcers (defined as a mucosal defect of 3 mm or more in diameter) in relation to the use of antiplatelet treatment for concomitant cardiovascular disease.
  
  
  METHODS
  Sixty-two patients with CRP were included in this retrospective study. Patients underwent pelvic irradiation due to prostate cancer (n = 28), cervical cancer (n = 16), endometrial cancer (n = 17) or rectal cancer (n = 1). APC was performed in all patients. Control endoscopies were performed at 8 and 16 weeks after enrolment.
  
  
  RESULTS
  Rectal ulcers were observed after APC in 35 (56%) patients. They were symptomatic in 5 and asymptomatic in 30. The 20 (32%) patients who were on antiplatelet therapy had a significantly lower risk of ulceration after APC (OR = 0.21; 95% CI 0.049-0.91; P = 0.019). The number of symptomatic ulcers (5% vs 10%; P = 1.0) and asymptomatic ulcers alone (30% vs 58%; P = 0.06) was also lower in patients respectively taking and not taking antiplatelet therapy, but these differences did not reach statistical significance.
  
  
  CONCLUSIONS
  Argon plasma coagulation-related ulceration in patients treated for CRP is less common when concomitant antiplatelet treatment is administered. This preliminary finding suggests that antiplatelet therapy may benefit patients treated with APC for CRP.
authors.affiliation: Department of Gastroenterology and Hepatology, Medical Center for Postgraduate Education, Warsaw, Poland; Department of Gastroenterology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
authors.forename: M R
authors.initials: MR
authors.lastname: Chruscielewska-Kiliszek
authors.forename: M
authors.initials: M
authors.lastname: Rupinski
authors.forename: E
authors.initials: E
authors.lastname: Kraszewska
authors.forename: J
authors.initials: J
authors.lastname: Pachlewski
authors.forename: J
authors.initials: J
authors.lastname: Regula
mesh_terms: D000368:Aged; D057908:Argon Plasma Coagulation / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy*; D002908:Chronic Disease; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000532:radiotherapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000532:radiotherapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011349:Proctitis / Q000150:complications / Q000628:therapy*; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011832:Radiation Injuries / Q000150:complications / Q000628:therapy*; D012002:Rectal Diseases / Q000209:etiology; D012004:Rectal Neoplasms / Q000532:radiotherapy; D012189:Retrospective Studies; D014456:Ulcer / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Endoscopy; gastroenterology; oncology