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Formaldehyde application for haemorrhagic radiation-induced proctitis: a clinical and histological study
R C Chautems1, X Delgadillo, L Rubbia-Brandt
1Outpatient Department, Unit of Proctology, University Hospital of Geneva, Micheli-du-Crest 24, 1211 Geneva 14, Switzerland.
Summary
Formaldehyde treatment effectively stops bleeding from radiation-induced proctitis. This method is well-tolerated and causes minimal rectal tissue damage, offering a good solution for this radiotherapy complication.
Area of Science:
- Gastroenterology
- Radiation Oncology
- Colorectal Surgery
Background:
- Radiation-induced proctitis is a severe complication of pelvic radiotherapy.
- Massive hemorrhage can necessitate hospitalization and transfusions.
- Formaldehyde application is an efficient treatment option.
Purpose of the Study:
- To evaluate the efficacy of 4% formaldehyde in treating hemorrhagic radiation-induced proctitis.
- To assess histological changes in rectal mucosa post-formaldehyde treatment.
Main Methods:
- 13 patients with hemorrhagic radiation-induced proctitis were treated with 4% formaldehyde cotton-soaked applications.
- Follow-up was conducted for up to one year.
- Endoscopic biopsies were taken before treatment, immediately after, at 1 month, and at 1 year.
Main Results:
- Bleeding stopped after the first application in 8 patients.
- Two patients required a second application, and two needed four applications.
- No acute proctitis or rebleeding occurred at 12-month follow-up.
- Histology showed vessel thrombosis without deep lesions.
Conclusions:
- Local 4% formaldehyde application is effective and well-tolerated for hemorrhagic radiation-induced proctitis.
- The treatment selectively induces thrombosis in bleeding vessels.
- Histological changes are limited to chronic effects of radiotherapy.
