Abstract
Background
Chronic radiation proctitis (CRP) occurs up to 20 % of patients after pelvic radiotherapy, with rectal bleeding as the main presenting complaint. Radiofrequency ablation (RFA) has recently been used in the management of Barrett’s esophagus, but its efficacy in CRP has to be studied. The aim of this case series was to describe four cases of patients with CRP treated with RFA that demonstrate the efficacy and safety of the technique.
Methods
All the procedures were performed with HALO 90 or HALO 90 Ultra ablation catheter fitted on the distal end of a standard flexible endoscope. For each patient, the severity of symptoms was assessed at baseline and after the last treatment session.
Results
At least two sessions of RFA (maximum 4) were necessary, at three-month intervals, to completely control the symptoms. No major complications were observed.
Conclusions
RFA was effective and safe for control bleeding in this case series. Adequately powered randomized controlled trials are needed to establish the safety and efficacy of RFA for CRP.
References
Cho KH, Lee CK, Levitt SH (1995) Proctitis after conventional external radiation therapy for prostate cancer: importance of minimizing posterior rectal dose. Radiology 195:699–703
Haboubi NY, Schofield PF, Rowland PL (1988) The light and electron microscopic features of early and late phase radiation-induced proctitis. Am J Gastroenterol 83:1140–1144
Rustagi T, Mashimo H (2011) Endoscopic management of chronic radiation proctitis. World J Gastroenterol 17:4554–4562
Trunzo JA, McGee MF, Poulose BK (2011) A feasibility and dosimetric evaluation of endoscopic radiofrequency ablation for human colonic and rectal epithelium in a treat and resect trial. Surg Endosc 25:491–496
Nikfarjam M, Falux A, Laughinghouse M, Marks JM (2010) Feasibility of radiofrequency ablation for the treatment of chronic radiation proctitis. Surg Innov 17:92–94
Ehrenpreis ED, Jani A, Levitsky J, Ahn J, Hong J (2005) A prospective, randomized, double-blind, placebo controlled trial of retinol palmitate (vitamin A) for symptomatic chronic radiation proctitis. Dis Colon Rectum 48:1–8
Sharma VK, Wang KK, Overholt BF et al (2007) Balloon-based, circumferential, endoscopic radiofrequency ablation of Barrett’s esophagus: 1-year follow-up of 100 patients. Gastrointest Endosc 65:185–195
Zhou C, Adler D, Becker L (2009) Effective treatment of chronic radiation proctitis using radiofrequency ablation. Therap Adv Gastroenterol 1:149–156
Swan MP, Moore GT, Sievert W, Devonshire DA (2010) Efficacy and safety of single-session argon plasma coagulation in the management of chronic radiation proctitis. Gastrointest Endosc 72:150–154
Luna-Pérez P, Rodríguez-Ramírez SE (2002) Formalin instillation for refractory radiation-induced hemorrhagic proctitis. J Surg Oncol 80:41–44
Pricolo VE, Shellito PC (1994) Surgery for radiation injury to the large intestine: variables influencing outcome. Dis Colon Rectum 37:675–684
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Supplementary material 1 (MPG 14320 kb)
Supplementary material 2 (MPG 14478 kb)
Supplementary material 3 (MPG 24082 kb)
Rights and permissions
About this article
Cite this article
Pigò, F., Bertani, H., Manno, M. et al. Radiofrequency ablation for chronic radiation proctitis: our initial experience with four cases. Tech Coloproctol 18, 1089–1092 (2014). https://doi.org/10.1007/s10151-014-1178-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10151-014-1178-0