A Randomized Controlled Trial of Novel Treatment for Hemorrhagic Radiation Proctitis

Autor: Wei Chieng Pui, Nik Azim Nik Abdullah, Sze Li Siow, Ismail Sagap, Tiong How Chieng
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Adult
medicine.medical_specialty
Radiation proctitis
medicine.drug_class
Treatment outcome
Antibiotics
water irrigation
oral antibiotics
Administration
Oral
Argon plasma coagulation
Gastroenterology
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Anti-Infective Agents
law
Internal medicine
Formaldehyde
Metronidazole
Water irrigation
medicine
Electrocoagulation
Humans
Proctitis
Radiation Injuries
Therapeutic Irrigation
Aged
Pelvic Neoplasms
Radiotherapy
business.industry
Hemorrhagic radiation proctitis
General Medicine
Middle Aged
medicine.disease
formalin
Ciprofloxacin
030104 developmental biology
030220 oncology & carcinogenesis
Female
per rectal bleeding
business
Gastrointestinal Hemorrhage
Treatment Arm
medicine.drug
Research Article
Disinfectants
Follow-Up Studies
Zdroj: Asian Pacific Journal of Cancer Prevention : APJCP
ISSN: 2476-762X
1513-7368
Popis: Background Various methods have been used for treatment of hemorrhagic radiation proctitis (HRP) with variable results. Currently, the preferred treatment is formalin application or endoscopic therapy with argon plasma coagulation. Recently, a novel therapy with colonic water irrigation and oral antibiotics showed promising results and more effective compared to 4% formalin application for HRP. The study objective is to compare the effect of water irrigation and oral antibiotics versus 4% formalin application in improving per rectal bleeding due to HRP and related symptoms such as diarrhoea, tenesmus, stool frequency, stool urgency and endoscopic findings. Methods We conducted a study on 34 patients with HRP and randomly assigned the patients to two treatment arm groups (n=17). The formalin group underwent 4% formalin dab and another session 4 weeks later. The irrigation group self-administered daily rectal irrigation at home for 8 weeks and consumed oral metronidazole and ciprofloxacin during the first one week. We measured the patients' symptoms and endoscopic findings before and after total of 8 weeks of treatment in both groups. Results Our study showed that HRP patients had reduced per rectal bleeding (p = 0.003) in formalin group, whereas irrigation group showed reduced diarrhoea (p=0.018) and tenesmus (p=0.024) symptoms. The comparison between the two treatment arms showed that irrigation technique was better than formalin technique for tenesmus (p=0.043) symptom only. Conclusion This novel treatment showed benefit in treating HRP. It could be a new treatment option which is safe and conveniently self-administered at home or used as a combination with other therapies to improve the treatment outcome for HRP. .
Databáze: OpenAIRE
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