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Argon plasma coagulation for rectal bleeding after prostate brachytherapy
S Smith1, K Wallner, J A Dominitz
1Department of Radiation Oncology, University of Washington, Seattle, WA, USA.
International Journal of Radiation Oncology, Biology, Physics
|October 13, 2001
Summary
Argon plasma coagulation (APC) effectively treated persistent rectal bleeding in patients with brachytherapy-related proctitis. This safe and beneficial treatment showed no progressive tissue damage in the studied cases.
Area of Science:
- Oncology
- Gastroenterology
- Radiation Therapy
Background:
- Radiation proctitis affects 2-10% of prostate cancer patients post-brachytherapy.
- Optimal treatment for persistent bleeding remains unclear due to limited data.
- Previous studies lacked specific dosimetric information and grouped diverse radiation cases.
Purpose of the Study:
- To evaluate the efficacy and safety of argon plasma coagulation (APC) for brachytherapy-related proctitis.
- To define APC's role in managing persistent rectal bleeding after prostate brachytherapy.
Main Methods:
- Seven patients with persistent rectal bleeding due to prostate brachytherapy-related proctitis were treated with APC.
- Treatments were administered every 4-8 weeks using an argon plasma coagulator (1.6 L/min gas flow, 40-45 W power).
- Four patients also received supplemental external beam radiation.
Main Results:
- Five of seven patients experienced complete resolution of rectal bleeding after 1-3 APC sessions.
- Bleeding onset occurred 3-18 months post-implantation; APC was initiated 9-22 months post-implantation.
- No patients developed progressive rectal wall abnormalities during 4-13 months of follow-up.
Conclusions:
- Argon plasma coagulation (APC) demonstrates efficacy and safety for treating brachytherapy-related proctitis with persistent bleeding.
- The procedure resulted in significant symptom relief for most patients without adverse tissue effects.
- Caution is advised when considering APC for brachytherapy patients, particularly regarding specific rectal radiation doses.