Preliminary clinical analysis of radiation proctitis treated with argon plasma coagulation combined with submucosal injection
10.3760/cma.j.issn.1004-4221.2020.01.008
- VernacularTitle: 氩离子凝固术加黏膜下药物注射治疗放射性肠炎初步临床分析
- Author:
Guanlin LU
1
;
Shilin FANG
2
;
Yanan PENG
1
;
Qiu ZHAO
1
;
Xianyan SHI
;
Jing LIU
Author Information
1. Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
2. Department of Pain, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Publication Type:Journal Article
- Keywords:
Radiation proctitis/argon plasma coagulation;
Radiation proctitis/combined therapy;
Treatment outcome
- From:
Chinese Journal of Radiation Oncology
2020;29(1):35-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To preliminarily evaluate the clinical efficacy of endoscopic argon plasma coagulation (APC) combined with sub-mucosal injection of norepinephrine saline in the treatment of radiation proctitis (RP), especially for refractory RP.
Methods:Clinical data of 22 RP patients were retrospectively analyzed. The severity of RP was evaluated by a modified endoscopy scoring system (A) or Sherman′s classification (B). The criteria of successful treatment are the improvement of clinical symptoms or the cessation of bleeding (or only occasional traces of blood on the stools that do not need further treatment).
Results:All 22 patients were successfully treated. Among them, 18 patients (82%) had no bleeding. According to the classification of A, 15 patients (68%) had mild proctitis and 7(32%) experienced severe proctitis. Based on B classification, 9 patients (41%) were categorized as mild proctitis and 13(59%) as severe proctitis. Using the classification of A, the number of treatment sessions was significantly correlated with the endoscopic grade (or endoscopic total score)(Spearman’s r=0.86, P<0.001).
Conclusions:Preliminary evidence demonstrates that endoscopic APC combined with sub-mucosal injection of norepinephrine saline is not only effective for mild and moderate RP, but also maintains long-term efficacy for refractory RP. Modified endoscopy scoring system (A) assessment is more suitable for clinical application compared with B assessment.
