| Abstract | PURPOSE: Chronic radiation proctopathy occurs in 5 to 20% of patients receiving radiation therapy, with rectal bleeding as its most common presentation. Although formalin treatment for rectal bleeding is promising, improvement is possible. Given the success of vitamin A in other radiation-induced treatments, we studied the efficacy of combining formalin with vitamin A in controlling bleeding symptoms of chronic radiation proctopathy. METHODS: A retrospective review (1993-2007) was performed of patients presenting with features of chronic radiation proctopathy. Formalin 8% in a buffered solution was applied to the affected mucosa with use a tip applicator, and 10,000 units of vitamin A were given orally on a daily basis. Formalin treatments were repeated at three-week to four-week intervals until symptoms resolved. RESULTS: A comparison was made between patients who received formalin alone (n = 30) and those who received formalin in combination with vitamin A (n = 34). The 64 patients had a mean age of 79 years (range, 54-90 years). The combination group required fewer treatments (mean, 1.9) and a shorter time (11 weeks) for resolution of symptoms compared with the formalin-alone group (mean, 5.2 and 31 weeks, respectively) (P < 0.001). The overall success rate in controlling bleeding was only 64% in the formalin-alone group when compared with 94% in the combination group. CONCLUSIONS: When vitamin A was added to the regimen, a significant reduction was observed in the number of treatments and the time needed for resolution of symptoms, and there was an increased overall success rate. This combination represents a simple, effective, and well tolerated method of controlling hemorrhagic chronic radiation proctopathy. |
| Authors | Purnal Patel, Gokulakkrishna Subhas, Aditya Gupta, Yeon-Jeen Chang, Vijay K Mittal, Alasdair McKendrick
(Affiliation: Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA.)
|
| Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 52
Issue 9
Pg. 1605-9
(Sep 2009)
ISSN: 1530-0358 [Electronic] United States |
| PMID | 19690489
(Publication Type: Journal Article)
|
| Chemical References |
- Sclerosing Solutions
- Vitamins
- Vitamin A
- Formaldehyde
|
| Topics |
- Administration, Oral
- Aged
- Aged, 80 and over
- Carcinoma
(radiotherapy)
- Cohort Studies
- Dietary Supplements
- Formaldehyde
(administration & dosage)
- Gastrointestinal Hemorrhage
(etiology, therapy)
- Humans
- Male
- Middle Aged
- Prostatic Neoplasms
(radiotherapy)
- Radiation Injuries
(etiology, therapy)
- Radiotherapy
(adverse effects)
- Rectal Diseases
(etiology, therapy)
- Retrospective Studies
- Sclerosing Solutions
(administration & dosage)
- Treatment Outcome
- Vitamin A
(administration & dosage)
- Vitamins
(administration & dosage)
|
