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Title: Long-term control of refractory hemorrhagic radiation proctitis with ozone therapy
Authors: Clavo, Bernardino 
Ceballos Santos, Daniel Sebastián 
Gutierrez, Dominga
Rovira, Gloria
Suarez, Gerardo
López Ríos,Laura 
Pinar Sedeño, María Beatriz 
Cabezón Pons, María Auxiliadora 
Morales, Victoria
Oliva, Elena
Fiuza Pérez, Mª Dolores 
Santana Rodríguez, Norberto 
UNESCO Clasification: 32 Ciencias médicas
3201 Ciencias clínicas
Keywords: Gynecologic tumors
Integrative and complementary medicine
Pelvic radiotherapy
Prostate cancer
Rectal bleeding, et al
Issue Date: 2013
Journal: Journal of Pain and Symptom Management 
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 10.35 g/dL (7–14 g/dL) pre-O3T and 13 g/dL (9–15 g/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.
ISSN: 0885-3924
DOI: 10.1016/j.jpainsymman.2012.06.017
Source: Journal of Pain and Symptom Management[ISSN 0885-3924],v. 46, p. 106-112
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