Sucralfate or placebo following argon plasma coagulation for chronic radiation proctitis: a randomized double blind trial

被引:25
作者
Chruscielewska-Kiliszek, M. R. [1 ,2 ,3 ]
Regula, J. [1 ,2 ]
Polkowski, M. [1 ,2 ]
Rupinski, M. [1 ,2 ]
Kraszewska, E. [1 ]
Pachlewski, J. [1 ,2 ]
Czaczkowska-Kurek, E. [1 ,2 ]
Butruk, E. [1 ,2 ]
机构
[1] Med Ctr Postgrad Educ, Dept Gastroenterol & Hepatol, Warsaw, Poland
[2] Maria Sklodowska Curie Mem Canc Ctr, Dept Gastroenterol, Warsaw, Poland
[3] Inst Oncol, Dept Gastroenterol & Hepatol, PL-02781 Warsaw, Poland
关键词
Post-radiation injury; proctopathy; radiotherapy; argon plasma coagulation; PROSTATE-CANCER; RADIOTHERAPY; OUTCOMES; THERAPY;
D O I
10.1111/codi.12035
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim Chronic radiation proctitis is a long-term complication of radiation therapy for pelvic malignancy. The aim of this study was to compare the efficacy and safety of two treatment regimens, sucralfate or placebo, following argon plasma coagulation (APC) for chronic haemorrhagic radiation proctitis. Method A single-centre, randomized, placebo-controlled, double-blind study was performed on patients with haemorrhagic chronic radiation proctitis after irradiation for prostate, uterine, cervical, rectal or vaginal cancer. All patients received APC, and were then randomized to oral sucralfate (6 g twice a day) or placebo treatment for 4 weeks. APC was repeated every 8 weeks if necessary after the first session. Patients were graded clinically and endoscopically according to the Chutkan and Gilinski scales before and at 8 and 16 weeks after initial APC treatment (1.5-2 l/min, 25-40 W) and after 52 weeks (clinical only). Results Of 122 patients, 117 completed the entire protocol, with 57/60 in the sucralfate group and 60/62 in the placebo group. At baseline there were no significant differences between the sucralfate and placebo groups. At 1 year, a significant improvement in the clinical scale in both groups occurred compared with baseline. After 16 weeks, the median overall clinical severity scores fell from 4 to 2 points and the median bleeding score from 2 to 0 in both groups. Conclusion APC is safe and effective for the management of chronic radiation proctitis. Additional sucralfate treatment did not influence the clinical or endoscopic outcome.
引用
收藏
页码:E48 / E55
页数:8
相关论文
共 28 条
[1]  
[Anonymous], GASTROINTEST ENDOSC
[2]  
[Anonymous], 2011, GASTROENT RES PRACT, DOI DOI 10.1155/2011/917941
[3]  
[Anonymous], DIG DIS SCI
[4]   Argon plasma coagulation in the treatment of hemorrhagic radiation proctitis is efficient but requires a perfect colonic cleansing to be safe [J].
Ben-Soussan, E ;
Antonietti, M ;
Savoye, G ;
Herve, S ;
Ducrotté, P ;
Lerebours, E .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2004, 16 (12) :1315-1318
[5]   PROCTITIS AFTER CONVENTIONAL EXTERNAL RADIATION-THERAPY FOR PROSTATE-CANCER - IMPORTANCE OF MINIMIZING POSTERIOR RECTAL DOSE [J].
CHO, KH ;
LEE, CKK ;
LEVITT, SH .
RADIOLOGY, 1995, 195 (03) :699-703
[6]   OUTCOMES OF ENDOSCOPY PROCEDURES - STRUGGLING TOWARDS DEFINITIONS [J].
COTTON, PB .
GASTROINTESTINAL ENDOSCOPY, 1994, 40 (04) :514-518
[7]   Is there more than one late radiation proctitis syndrome? [J].
Denham, JW ;
O'Brien, PC ;
Dunstan, RH ;
Johansen, J ;
See, A ;
Hamilton, CS ;
Bydder, S ;
Wright, S .
RADIOTHERAPY AND ONCOLOGY, 1999, 51 (01) :43-53
[8]   Argon beam coagulation for treatment of symptomatic radiation-induced proctitis [J].
Fantin, AC ;
Binek, J ;
Suter, WR ;
Meyenberger, C .
GASTROINTESTINAL ENDOSCOPY, 1999, 49 (04) :515-518
[9]   Radiation proctopathy in the treatment of prostate cancer [J].
Garg, Amit K. ;
Mai, Wei-Yuan ;
McGary, John E. ;
Grant, Walter H., III ;
Butler, E. Brian ;
Teh, Bin S. .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2006, 66 (05) :1294-1305
[10]  
GILINSKY NH, 1983, Q J MED, V52, P40