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Four percent formalin application for the management of radiation proctitis in carcinoma cervix patients: An effective, safe, and economical practice


1 Department of Gastroenterology, IGMC, Shimla, Himachal Pradesh, India
2 Department of Radiotherapy, Cancer Hospital, IGMC, Shimla, Himachal Pradesh, India
3 Department of Anatomy, IGMC, Shimla, Himachal Pradesh, India
4 Department of Physiology, IGMC, Shimla, Himachal Pradesh, India
5 Department of Radiotherapy, IGMC, Shimla, Himachal Pradesh, India
6 Department of Microbiology, IGMC, Shimla, Himachal Pradesh, India

Correspondence Address:
Manish Gupta,
Department of Radiotherapy, Cancer Hospital, IGMC, Shimla, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_393_17

Context: Radiotherapy is a very effective treatment modality for pelvic malignancies such as carcinoma of the cervix. However, it is quite common for chronic radiation proctitis (CRP) to manifest after radical radiotherapy. CRP is a source of significant morbidity, and there is a lack of effective treatment modalities. There also exists a general lack of guidelines on management of CRP. Aims: To assess the benefit from 4% formalin application for the treatment of Grade >2 CRP among patients previously treated with radical radiotherapy for cervical carcinoma. Settings and Design: This retrospective descriptive study involved 29 eligible patients who were treated from November 2010 - November 2015 for CRP with 4% formalin application. Materials and Methods: Of the 1864 patients of carcinoma cervix treated during the said patients, 29 patients fulfilled the eligibility criteria. Eligible patients were invited telephonically for follow-up and were assessed for response and complications of the procedure. Results: The treatment of hemorrhagic radiation proctitis with local formalin instillation is effective, well tolerated and safe procedure. The procedure is inexpensive, technically simple and can be done on an outpatient basis. 62% patients had complete freedom from rectal bleed, while 34.5% patients had partial benefit. Only one patient required diversion colostomy for persistent bleeding.


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    -  Sharma B
    -  Gupta M
    -  Sharma R
    -  Gupta A
    -  Sharma N
    -  Sharma M
    -  Sharma V
    -  Vats S
    -  Gupta M
    -  Seam RK
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