Long-term control of refractory hemorrhagic radiation proctitis with ozone therapy
Bernardino Clavo, Daniel Ceballos, Dominga Gutierrez, Gloria Rovira, Gerardo Suarez, Laura Lopez, Beatriz Pinar, Auxiliadora Cabezon, Victoria Morales, Elena Oliva, Dolores Fiuza, Norberto Santana-Rodriguez, Bernardino Clavo, Daniel Ceballos, Dominga Gutierrez, Gloria Rovira, Gerardo Suarez, Laura Lopez, Beatriz Pinar, Auxiliadora Cabezon, Victoria Morales, Elena Oliva, Dolores Fiuza, Norberto Santana-Rodriguez
Abstract
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-O3T, 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.
Keywords: Gynecologic tumors; integrative and complementary medicine; pelvic radiotherapy; prostate cancer; rectal bleeding; side effects; toxicity.
Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Source: PubMed