Stern D R, Steinhagen R M
Division of Colon and Rectal Surgery, Department of Surgery, Mount Sinai School of Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.
Colorectal Dis. 2007 Mar;9(3):275-8. doi: 10.1111/j.1463-1318.2006.01106.x.
Topical formalin has been used as an effective treatment for haemorrhagic radiation proctitis. In the course of reviewing our experience with this modality, we identified two patients who developed anorectal cancer during the follow-up period.
From 2001 to 2005, 49 patients who received pelvic radiation for treatment of prostate, rectal or endometrial cancer subsequently developed haemorrhagic radiation proctitis. Four percent formalin was applied in the office setting under direct visualization with a rigid proctoscope and without sedation. Response to treatment was then reviewed.
Seventy-eight per cent of patients reported a complete response to formalin application. Only 14% were refractory to formalin treatment. Two patients subsequently presented with anorectal cancer.
Topical formalin application in the outpatient setting appears to be an effective first-line treatment for haemorrhagic radiation proctitis. We report the first cases of anorectal cancer which developed subsequent to formalin application. Pelvic irradiation is known to increase the risk of developing a second malignancy, therefore it is impossible to determine what, if any, role formalin application played in the development of the second malignancies.
局部应用福尔马林一直被用作治疗出血性放射性直肠炎的有效方法。在回顾我们使用这种治疗方式的经验过程中，我们发现有两名患者在随访期间患上了肛管直肠癌。
2001年至2005年期间，49例因前列腺癌、直肠癌或子宫内膜癌接受盆腔放疗的患者随后患上了出血性放射性直肠炎。在硬性直肠镜直视下且未使用镇静剂的情况下，于诊室局部应用4%的福尔马林。然后评估治疗反应。
78%的患者报告对福尔马林治疗完全有效。只有14%的患者对福尔马林治疗无效。两名患者随后患上了肛管直肠癌。
在门诊环境中局部应用福尔马林似乎是治疗出血性放射性直肠炎的一种有效的一线治疗方法。我们报告了首例在应用福尔马林后发生的肛管直肠癌病例。盆腔放疗已知会增加发生第二种恶性肿瘤的风险，因此无法确定福尔马林应用在第二种恶性肿瘤的发生中起到了何种作用（如果有作用的话）。
