Argon plasma coagulation and hyperbaric oxygen therapy in chronic radiation proctopathy, effectiveness and impact on tissue toxicity

Alvaro-Villegas, Julio; Sobrino-Cossío, Sergio; Tenorio-TéLlez, Luisa; Mora-Levy, José Guillermo de la; Hernández-Guerrero, Angélica; Alonso-Lárraga, Juan Octavio; Vela-Chávez, Teresa

doi:10.4321/s1130-01082011001100004

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…However, most studies in this systematic review used the firstgeneration APC machine (ICC/APC 300 system; Erbe Elektromedizin, Tuebingen, Germany), which may not be available in most endoscopy units. 16,18,19,21,[24][25][26]28,29,32,33,37,39,40,44,46,48 Only 3 studies used the second-generation APC machine (VIO APC/APC 2; Erbe Elektromedizin). 17,31,46 Comparative studies.…”

Section: Argon Plasma Coagulationmentioning

confidence: 99%

“…Although we identified 2 scoring systems in the literature, further validation is required before implementation of these scoring systems in clinical practice. 18,53 Without these fundamental elements, future trials and comparative studies will not have a meaningful impact on this debilitating condition. Additional prospective studies on the safety and efficacy of the latest-generation cryoablation system for management of chronic radiation proctopathy should be pursued.…”

Section: Future Directionsmentioning

confidence: 99%

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ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy

Lee

Agrawal

Thosani

et al. 2019

Gastrointestinal Endoscopy

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Chronic radiation proctopathy is a common sequela of radiation therapy for malignancies in the pelvic region. A variety of medical and endoscopic therapies have been used for the management of bleeding from chronic radiation proctopathy. In this guideline, we reviewed the results of a systematic search of the literature from 1946 to 2017 to formulate clinical questions and recommendations on the role of endoscopy for bleeding from chronic radiation proctopathy. The following endoscopic modalities are discussed in our document: argon plasma coagulation, bipolar electrocoagulation, heater probe, radiofrequency ablation, and cryoablation. Most studies were small observational studies, and the evidence for effectiveness of endoscopic therapy for chronic radiation proctopathy was limited because of a lack of controlled trials and comparative studies. Despite this limitation, our systematic review found that argon plasma coagulation, bipolar electrocoagulation, heater probe, and radiofrequency ablation were effective in the treatment of rectal bleeding from chronic radiation proctopathy. (Gastrointest Endosc 2019;90:171-82.)

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Section: Argon Plasma Coagulationmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy

Lee

Agrawal

Thosani

et al. 2019

Gastrointestinal Endoscopy

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“…A total of 330 participants were included in the selected studies, which were published from 1997 to 2016. The characteristics of the studies were displayed in Table 1: of the 12 studies selected for review, only 1 inclusion was a prospective study (36), two were RCTs (18,28), and 9 selections were retrospective studies (29-35, 37, 38). The available data showed that the average age of the patients was 66 years old.…”

Section: Study Characteristics Of Rectal Bleedingmentioning

confidence: 99%

“…The authors reported that APC and HBO were both effective and safe, while the clinical response onset was faster in the APC group. However, two patients in the APC group had persistent rectal bleeding and were considered treatment failures, and then they were referred for HBO, and both had clinical improvement thereafter (36), suggesting the potential roles of HBO for refractory rectal bleeding treatment.…”

Section: Rectal Bleedingmentioning

confidence: 99%

The Effects of Hyperbaric Oxygen Therapy on Pelvic Radiation Induced Gastrointestinal Complications (Rectal Bleeding, Diarrhea, and Pain): A Meta-Analysis

et al. 2020

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Background: Radiotherapy is a routine treatment for pelvic cancer patients. While it had been proven effective, gastrointestinal side effects remain a concern, impairing the quality of life. A few studies focused on the effects of hyperbaric oxygen (HBO) treatment to alleviate radiation-induced gastrointestinal complications. This meta-analysis aimed to critically review and summarize existing literature, assessing the effectiveness of HBO therapy for the treatment of radiation-induced gastrointestinal side effects. Methods: Medical literature search was performed with PubMed, Cochrane Library, and EMBASE up to March 14, 2019. Literatures about HBO treatment upon patients undergoing pelvic cancer (endometrial, cervix, rectum, or prostate cancers) radiotherapy were collected, and the effects of HBO treatment on radiotherapy-induced gastrointestinal complications were evaluated. A random-effects model was used to calculate the pooled effect size. Subgroup analyses were performed to search for sources of heterogeneity. Publication bias was detected with Funnel plots and Egger's test. Results: Three different radiotherapy-related gastrointestinal complications, including rectal bleeding, diarrhea, and pain, were analyzed after screening. It was revealed that the improvement rates were considerable in rectal bleeding (0.81, 95% CI: 0.74-0.89) and diarrhea (0.75, 95% CI: 0.61-0.90) and slightly in pain (0.58, 95% CI: 0.38-0.79). Subgroup analysis revealed factors that significantly influenced the heterogeneity of rectal bleeding, diarrhea, and pain (evaluation criteria, follow-up time, and scoring system, respectively). No significant publication bias was detected. Conclusion: HBO treatment might have the potential to alleviate radiotherapy-related gastrointestinal complications, including rectal bleeding, diarrhea, and pain, but more data are needed for further conclusions. Other symptoms were not further analyzed, as the number of studies was insufficient. More large-scale and prospective studies are needed for better evaluation of HBO's therapeutic values.

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“…Zur Therapie von Blutungen im Rahmen einer Strahlenproktitis ist insbesondere die APC etabliert [232], wenngleich vergleichende Studien vergleichbare Effektivität auch für die hyperbare Sauerstofftherapie [233] bzw. die bipolare Koagulation [234] zeigen.…”

Section: Vaskuläre Malformationenunclassified

S2k-Leitlinie Gastrointestinale Blutung

Götz

Anders²,

Biecker³

et al. 2017

Z Gastroenterol

149

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Argon plasma coagulation and hyperbaric oxygen therapy in chronic radiation proctopathy, effectiveness and impact on tissue toxicity

Cited by 13 publications

References 18 publications

ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy

ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy

The Effects of Hyperbaric Oxygen Therapy on Pelvic Radiation Induced Gastrointestinal Complications (Rectal Bleeding, Diarrhea, and Pain): A Meta-Analysis

S2k-Leitlinie Gastrointestinale Blutung

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