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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
PubMed
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.

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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).

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  • 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.