Ozone Therapy in the Management of Persistent Radiation-Induced Rectal Bleeding in Prostate Cancer Patients

الملخص EN

Introduction.

Persistent radiation-induced proctitis and rectal bleeding are debilitating complications with limited therapeutic options.

We present our experience with ozone therapy in the management of such refractory rectal bleeding.

Methods.

Patients (n=12) previously irradiated for prostate cancer with persistent or severe rectal bleeding without response to conventional treatment were enrolled to receive ozone therapy via rectal insufflations and/or topical application of ozonized-oil.

Ten (83%) patients had Grade 3 or Grade 4 toxicity.

Median follow-up after ozone therapy was 104 months (range: 52–119).

Results.

Following ozone therapy, the median grade of toxicity improved from 3 to 1 (p<0.001) and the number of endoscopy treatments from 37 to 4 (p=0.032).

Hemoglobin levels changed from 11.1 (7–14) g/dL to 13 (10–15) g/dL, before and after ozone therapy, respectively (p=0.008).

Ozone therapy was well tolerated and no adverse effects were noted, except soft and temporary flatulence for some hours after each session.

Conclusions.

Ozone therapy was effective in radiation-induced rectal bleeding in prostate cancer patients without serious adverse events.

It proved useful in the management of rectal bleeding and merits further evaluation.