title: Ozone Therapy in the Management of Persistent Radiation-Induced Rectal Bleeding in Prostate Cancer Patients.
abstract: Introduction. Persistent radiation-induced proctitis and rectal bleeding are debilitating complications with limited therapeutic options. We present our experience with ozone therapy in the management of such refractory rectal bleeding. Methods. Patients (n = 12) previously irradiated for prostate cancer with persistent or severe rectal bleeding without response to conventional treatment were enrolled to receive ozone therapy via rectal insufflations and/or topical application of ozonized-oil. Ten (83%) patients had Grade 3 or Grade 4 toxicity. Median follow-up after ozone therapy was 104 months (range: 52-119). Results. Following ozone therapy, the median grade of toxicity improved from 3 to 1 (p < 0.001) and the number of endoscopy treatments from 37 to 4 (p = 0.032). Hemoglobin levels changed from 11.1 (7-14) g/dL to 13 (10-15) g/dL, before and after ozone therapy, respectively (p = 0.008). Ozone therapy was well tolerated and no adverse effects were noted, except soft and temporary flatulence for some hours after each session. Conclusions. Ozone therapy was effective in radiation-induced rectal bleeding in prostate cancer patients without serious adverse events. It proved useful in the management of rectal bleeding and merits further evaluation.
authors.affiliation: Radiation Oncology, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain ; Chronic Pain, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain ; Experimental Surgery-Research Unit, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain ; Canary Islands Institute for Cancer Research (ICIC), 35.010 Las Palmas, Spain ; Spanish Group for Clinical Research in Radiation Oncology (GICOR), Madrid, Spain.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Clavo
authors.affiliation: Experimental Surgery-Research Unit, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain ; Canary Islands Institute for Cancer Research (ICIC), 35.010 Las Palmas, Spain.
authors.forename: Norberto
authors.initials: N
authors.lastname: Santana-Rodriguez
authors.affiliation: Experimental Surgery-Research Unit, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Llontop
authors.affiliation: Radiation Oncology, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain ; Canary Islands Institute for Cancer Research (ICIC), 35.010 Las Palmas, Spain.
authors.forename: Dominga
authors.initials: D
authors.lastname: Gutierrez
authors.affiliation: Gastroenterology, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ceballos
authors.affiliation: Experimental Surgery-Research Unit, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain.
authors.forename: Charlin
authors.initials: C
authors.lastname: Méndez
authors.affiliation: Ozone Therapy Unit, Quiron Hospital, 08.023 Barcelona, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Rovira
authors.affiliation: Radiation Oncology, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain ; Canary Islands Institute for Cancer Research (ICIC), 35.010 Las Palmas, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Suarez
authors.affiliation: Radiation Oncology, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain ; Canary Islands Institute for Cancer Research (ICIC), 35.010 Las Palmas, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Rey-Baltar
authors.affiliation: Radiation Oncology, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Garcia-Cabrera
authors.affiliation: Medical Center Beauty Benefit-San Biagio di Osimo, Osimo, 60.027 Ancona, Italy.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Martínez-Sánchez
authors.affiliation: Experimental Surgery-Research Unit, Dr. Negrin University Hospital, 35.010 Las Palmas, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Fiuza