Argon plasma coagulation for the treatment of chronic radiation proctitis – real-world data from Indonesian National Cancer Center

Lianda Siregar, I. Loho, A. Waspodo, Rahmanandhika Swadari, Benedicta Audrey Maharani
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Abstract

Background: This study aimed to evaluate the endoscopic features and clinical outcome of patients with chronic radiation proctitis (CRP) at one year after argon plasma coagulation (APC) treatment. Method: Between March 2016 and September 2019, a total of 48 female patients with CRP were treated with APC and their medical records were retrospectively reviewed. APC treatment was done every 3 to 54 weeks, with a median of 8 weeks. Number of APC was decided by the treating physician according to the severity of illness. Endoscopic and clinical features at one year after the final APC were recorded as the effectiveness of APC.Results: Of 48 patients, 26 patients were included in this study. Number of APC sessions varied between 1 to 5 sessions of APC for each patient. Of 26 patients, 22 patients achieved clinical improvement and four patients did not achieve clinical improvement at one year after the last APC session. Of the four patients who failed to achieve clinical improvement, two patients underwent surgery, one patient had occasional mild rectal bleeding, and one patient required regular transfusion. Of 22 patients with clinical improvement at one-year after the last APC, improvement of endoscopic features was found in 20 patients. Of four patients who did not achieve endoscopic improvement, diagnostic colonoscopy showed telangiectasis of more than 50% of rectal surface in 1 patient, presence of blood in 2 patients, and presence of ulceration of 1 cm in 1 patient.Conclusion: APC is an effective treatment option for CRP.
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氩等离子体凝固治疗慢性放射性直肠炎-来自印度尼西亚国家癌症中心的真实数据
背景:本研究旨在评估慢性放射性直肠炎(CRP)患者在氩等离子体凝固(APC)治疗一年后的内镜特征和临床结果。方法:对2016年3月至2019年9月48例女性CRP患者进行APC治疗,并对其病历进行回顾性分析。APC治疗每3 - 54周进行一次,中位数为8周。APC数量由主治医师根据病情严重程度决定。最后一次APC后一年的内镜和临床特征被记录为APC的有效性。结果:48例患者中,26例纳入本研究。每个患者的APC治疗次数在1到5次之间。在26例患者中,22例患者在最后一次APC治疗一年后达到临床改善,4例患者未达到临床改善。在未能取得临床改善的4名患者中,2名患者接受了手术,1名患者偶尔出现轻度直肠出血,1名患者需要定期输血。在最后一次APC术后1年临床改善的22例患者中,有20例患者的内镜特征得到改善。在4例未获得内镜改善的患者中,诊断性结肠镜检查显示1例患者直肠表面毛细血管扩张超过50%,2例患者存在血液,1例患者存在1cm溃疡。结论:APC是治疗CRP的有效选择。
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8 weeks
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