• Bernardino Clavo, Daniel Ceballos, Dominga Gutierrez, Gloria Rovira, Gerardo Suarez, Laura Lopez, Beatriz Pinar, Auxiliadora Cabezon, Victoria Morales, Elena Oliva, Dolores Fiuza, and Norberto Santana-Rodriguez.
• Radiation Oncology Department, Dr. Negrin University Hospital, Las Palmas, Spain. bernardinoclavo@gmail.com
• J Pain Symptom Manage. 2013 Jul 1;46(1):106-12.

ContextPersistent or severe hemorrhagic radiation proctitis (HRP) has limited therapeutic options.ObjectivesTo describe our experience with ozone therapy (O3T) in the management of refractory HRP.MethodsPatients (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).ResultsEndoscopic 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 10.35g/dL (7-14g/dL) pre-O3T and 13g/dL (9-15g/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.ConclusionPersistent 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.Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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