Table 3.
Literature on argon plasma coagulation therapy use in chronic radiation proctopathy
| Study Ref. | n | Mean age (yr) (range) | Settings -flow rate- power | Mean No. of sessions per patient | Responserate | Improvement in anemia (% patients), mean increase in Hgb (gm%) | Relief of transfusion dependency | Follow-up duration mean (mo) | Complications/Side effects | % requiring transfusion |
| Swan et al[49], 2010 | 50 | 72.1 (51-87) | 1.4-2 L/min, 50 W | 1.36 (1-3) | 96% | 1.9 gm% mean increase | 20.6 (6-48) | Short-term: 17 (34%) patients (proctalgia in 13, rectal mucous discharge in 4, incontinence in 1, fever in 1, and bleeding in 1); long-term: 1 (2%) asymptomatic rectal stricture | ||
| Karamanolis et al[46], 2009 | 56 | 68.4 (45–86) | 2.0 L/min, 40W | 2 (1-8) | Mild (100%), severe (79%), total (89%) | N/A | 7/9 | 17.9 (6-33) | one case of colonic explosion without perforation; No strictures or persistent ulcers; 2 on anticoagulation with recurrence | 9/56 (16%) |
| Tormo et al[74], 2009 | 22 | 74.3 | 2 L/min, 50 W | 2.58 (1-7), median-2 | 100% | N/A | N/A | N/A | None | 2/22 (9%) |
| Alfadhli et al[14], 2008 | 14 | 74.7 | 1.2-2 L/min, 45-50 W | 1.78 | 78.5% | 2 gm% mean increase | N/A | 3 | 2/14 (33.3%) mild | N/A |
| Latorre et al[75], 2008 | 38 | 70.9 | 3.6 ± 2.7 | mean2.7 gm% mean increase | 28 | |||||
| Dees et al[76],2006 | 48 | 2 L/min, 50 W | Median-3 | 98% | Two patients-recurrent blood loss on anticoagulation; 1-ulcer | 6/48 (12.5%) | ||||
| Ben-Soussan et al[53], 2004 | 27 | 73.1 (53-86) | 0.8-1.0 L/min, 40-50 W | 2.66 (1-7) | 92% | 13.6 (3-31) | Side effects-anal/rectal pain (n = 3), vagal symptoms (n = 2), 3 colonic explosions-1 with perforation requiring surgery, no stricture | 8/27 (30%) | ||
| Higuera et al[77], 2004 | 10 | 1.5-2.0 L/min, 60 W | 1.9 (1-4), median (2) | 100% | 1.5-1.9 gm% mean increase | 1/1 (100%) | 31.1 (10-45) | No ulcers/strictures, 1 (10%)-tenesmus | ||
| Sebastian et al[39], 2004 | 25 | 69 (53–77) | 1.5 L/min, 30 W (25-40 W) | median-1 | 21/25 (76%, 81% or 84%??) | 2.4 gm% mean increase | Median 14- | 1-rectal pain | ||
| Urban et al[78], 2004 | 8 | 1-4 | 100% | |||||||
| Ravizza et al[51], 2003 | 27 | 72 (62-83) | 3 L/min + 60 W (n = 17) reduced to 2 L/min and 40 W (n = 10) | 2 (1-5) | 85% marked improvement, 10/27 only had minor bleeding, 48% Complete resolution | 3.2 g/dL mean increase | 6/6 (100%) transfusion relief | 11.5 (1-24) | Short term-2/27 (7%), 1-transient anal/rectal pain, 1-fever; long-14/27 (52%)-asymptomatic rectal ulcers | 6/27 |
| Gheorghe et al[58], 2003 | 42 | 60 W (23), 50 W (19) | 1.34, 1.9 | |||||||
| Canard et al[48], 2003 | 30 | 70.7 (58-85) | 0.8-2 L/min, 30-80 W | 2.3 (1-5) | (87%) | 20 (3-35) | Overall-47%; 3 severe (10%): 1 severe bleeding, 1 extensive necrosis of lower part of rectum, 1 perforation. 3 microrectitis and 2 asymptomatic rectal stenosis. Post-Rx pain in 6 patients (20%) | 17% | ||
| Venkatesh et al[79], 2002 | 40 | 64-83 | 1-1.5 L/min, 40-60 W | Mean-1.35 median-1 (1-2) | 97.5% | - 97.5% patients | 20/21 (95.2%) | NR 3-30 | 1-urinary retention, 2-fever requiring antibiotics | 21/40 (52.5%) |
| Taieb et al[80], 2001 | 11 | 73 (54-86) | 0.8-2 L/min, 50W | 3.2 (1-5) | 82% CR, 18% PR | 3.8 gm% mean increase | 7/7 (100%) | 19 (7-30) | 7/11 (63.6%) | |
| Tjandra et al[41], 2001 | 12 | 1.5L/min, 40 W | 2 (1-3) | 50% CR, 50% PR, 83% Signi | 1.1 gm% mean increase | 4/4 (100%) | 11 (4-17) | None | 4/12 (33%) | |
| Smith et al[81], 2001 | 7 | 1.6 L/min, 40-45 W | 1-3 | 71% CR, 29% PR | 4-13 | None | ||||
| Rolachon et al[82], 2000 | 12 | 70.3 | 1.0 L/min, 50 W | Mean (2.8 ± 0.8) | 66% CR, 83% PR | 1.8 gm% mean increase | 6 | 3/12 (25%), 2-chronic rectal ulcerations, 1-asymptomatic rectal stenosis | ||
| Kaassis et al[44], 2000 | 16 | 73.5 (62-80) | 0.6 L/min, 40 W | Mean-3.7 (2-8) | 44% CR, 56% PR | 3/3 (100%) | 10.7 (8-28) | No | 3/16 (18.75%) | |
| Tam et al[40], 2000 | 15 | 2 L/min, 60 W | Median-2 (1-4) | 100% | 2.5 gm% mean increase | 3/3 (100%) | Median-24 (8-35) | 2-asymptomatic rectal strictures requiring dilation | 3/15 (20%) | |
| Silva et al[45], 1999 | 28 | 65 (42-77) | 1.5 L/min, 50 W | 2.9 (1-8) | 93% | 1.2 gm% mean increase | - | 10 (1-15) | No, 3-transient anal pain | 15/28 (53%) |
| Fantin et al[62], 1999 | 7 | 3 L/min, 60 W | 2 (2-4) | 100% | Median 24 (18-24) | No | ||||
| Chutkan et al[83], 1997 | 12 | 1 | 92% | 6.6 | No | 3/12 (25%) | ||||
| Villavicencio et al[50], 2002 | 21 | Median 72.6 ( 58-86) | 1.2-2.0 L/min, 45-50 W | 1.7 median (1-4) | 95% | 100% patients | 4/4 (100%) | 10.5 Median (1-29) | 4-rectal pain, tenesmus, diarrhea | 4/21 (19%) |
| Rotondano et al[84], 2003 | 24 | 0.8-1.2 L/min, 40 W | Median 2.5 | 100% | 1-RV Fistula | |||||
| Zinicola et al[42], 2003 | 14 | 2 L/min, 65 W | 2 (1-4) | 86%% | 3/3 (100%) | 19 (5-41) | 1-asymptomatic recto-sigmoid stenosis | 3/14 (21%) |