Comparison of Endoscopic Therapies for Chronic Radiation Proctitis: A Systematic Review and Meta-Analysis

Background: Radiation injury to the lower intestine may result following treatment of cancers of the pelvis. The rectum is most often affected. Argon plasma coagulation (APC), bipolar electro coagulation (BEC) and topical formalin are recognized as effective treatments. Objectives: This study aimed to determine in a systematic review and metaanalysis the most effective endoscopic therapy in the treatment of complications secondary Chronic Radiation Colo-Proctopathy (CRCP). Data sources: A systematic review of English and non-English articles using MEDLINE, COCHRANE, EMBASE, EBSCO, LILACS, Library University of Sao Paulo, BVS, and SCOPE. Criteria: The main outcome measures while undergoing endoscopic therapies are as follows: mean hemoglobin level before and after treatment, complications, and success in patients with chronic radiation Colo-Proctopathy (CRCP). Results: Three comparative studies were selected: one was a cohort study comparing APC with Formalin; the other two were unblinded randomized clinical trials with different comparisons (i.e., APC with BEC and APC with formalin). Based on the power of evidence from clinical trials and cohort studies, we can say that the APC seems to have the same efficacy as formalin and the BEC. Conclusions: The evidence for treatment modalities of CRCP is insufficient, although for endoscopic therapy APC appears to be the most promising treatment.


Fabio AC Bustamante, Eduardo GH de Moura, Bernardo W, Renata Nobre, Adriana V Safatle, Elisa Baba and Nelson Miyajima

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