CONTEXT: Persistent or severe hemorrhagic radiation proctitis (HRP) has limited therapeutic options.
OBJECTIVES: To describe our experience with ozone therapy (O3T) in the management of refractory HRP.
METHODS: Patients (n=17; median age 69 years [range 42-80 years]) previously irradiated for prostate or uterine cancer and suffering persistent or severe HRP without response to conventional treatment were enrolled to receive an O3/O2 gas mixture via rectal insufflations and topical application of ozonized oil. Most of the patients (83%) had Grade 3 or Grade 4 toxicity. Median follow-up post-O3T was 40 months (range 3-56 months).
RESULTS: Endoscopic treatments required were 43 (median 1; range 0-10) pre-O3T, 17 (median 0; range 0-8; P=0.063) during O3T, and five (median 0; range 0-2; P=0.008) during follow-up. Hemoglobin levels were 10.35g/dL (7-14g/dL) pre-O3T and 13g/dL (9-15g/dL) (P=0.001) post-O3T. Median toxicity grades were 3 (range 2-4) pre-O(3)T, 1 (range 0-2; P< 0.001) at the end of O3T, and 0 (range 0-1; P< 0.001) at the last follow-up.
CONCLUSION: Persistent advanced HRP was significantly improved with O3T. The addition of O3T can be useful as a complementary treatment in the long-term management of HRP and, as such, merits further evaluation.
Written by:
Clavo B, Ceballos D, Gutierrez D, Rovira G, Suarez G, Lopez L, Pinar B, Cabezon A, Morales V, Oliva E, Fiuza D, Santana-Rodriguez N. Are you the author?
Radiation Oncology Department, Dr. Negrin University Hospital, Las Palmas, Spain; Chronic Pain Unit, Dr. Negrin University Hospital, Las Palmas, Spain; Experimental Surgery-Research Unit, Dr. Negrin University Hospital, Las Palmas, Spain; Canary Islands Institute for Cancer Research (ICIC), Las Palmas, Spain; Grupo de Investigación Clínica en Oncología Radioterápica (GICOR), Madrid, Spain.
Reference: J Pain Symptom Manage. 2012 Oct 26. pii: S0885-3924(12)00402-2.
doi: 10.1016/j.jpainsymman.2012.06.017
PubMed Abstract
PMID: 23102757
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