- 期刊
Clinical Experience and Long-term Outcomes of Radiofrequency Ablation Treatment in Patients with Chronic Radiation Proctitis
慢性放射性直腸炎病人接受射頻燒灼術治療臨床經驗及長期追蹤
摘要
Purpose. Chronic radiation proctitis (CRP) may develop in patients who undergo pelvic radiotherapy. The optimal treatment modality is controversial, and it has several potential side effects. Herein, we report our experience using radiofrequency ablation (RFA) in patients with CRP. Methods. This was a single-center retrospective study. Between October 2015 and November 2018, 16 patients with CRP and severe rectal bleeding underwent RFA at our institution. The data of these patients, including sex, primary tumor site, symptoms, radiation dosage, and treatment, were collected for analysis. Results. A total of 16 patients who underwent RFA for CRP at Kaohsiung Chang Gung Memorial Hospital between October 2015 and November 2018 were enrolled in the study. We included 11 (68.7%) men and 5 (31.3%) women. Patient age ranged from 38 to 85 years, with a median of 69.4 years. The primary cancer site was the prostate, cervix, and rectum in nine (56.3%), five (31.3%), and two (12.4%) patients, respectively. All patients received either medical or endoscopic therapy prior to RFA. All patients experienced repeated rectal bleeding, and nine (56.3%) patients required blood transfusion. Most patients (93.7%) underwent RFA only once. One patient (6.3%) underwent a second RFA session due to recurrent hematochezia 16 weeks after the first RFA. The mean hemoglobin level improved from 10.9 ± 2.1 g/dL to 11.2 ± 2.2 g/dL. RFA treatment resulted in discontinuation of blood transfusion in all patients during the follow-up period. Conclusions. RFA treatment was safe and effective in controlling rectal bleeding in patients with CRP, and can be considered as a first-line endoscopic intervention in selected patients. Further controlled studies are required to confirm these findings.
並列摘要
目的：治療慢性放射性直腸炎的方法目前有不同種治療的方式，本篇研究旨在分享以射頻燒灼術治療慢性放射性直腸炎臨床經驗及長期追蹤。方法：回溯性分析單一醫學中心自2015年10月至2018年11月共16位接受射頻燒灼術的慢性放射性直腸炎合併嚴重直腸出血之病患，紀錄及分析病患性別、原發腫瘤位置、症狀、放射線劑量及治療。結果：病患族群平均年齡為69.4歲，含11位男性及5位女性。原發腫瘤位置依序為攝護腺9（56.3%）、子宮頸5（31.3%）以及直腸2（12.4%）。所有病患先前已接受過其他藥物或內視鏡治療，後因反覆性直腸出血而求診。有15位病患在接受一次射頻燒灼術後症狀得到改善，另一位在接受第二次的射頻燒灼術後症狀也緩解。經治療後可觀察到平均血色素上升，且在血便緩解後所有病人追蹤過程中均不需再接受輸血治療。結論：放射性直腸炎的病患接受射頻燒灼術可以得到有效且安全的症狀緩解，可以考慮成為針對反覆直腸出血病患的第一線內視鏡治療方式。