Hyperbaric oxygenation in treatment of chronic radiation proctitis; retrospective analyses of four years experience

OBJECTIVES

Radiation therapy is a key component in the control and eradication of malignant tumors. Late radiation tissue injury (LRTI) is a complication of radiotherapy and may occur several months to many years after completing the therapy. LRTI is progressive by its nature, and can be devastating due to the structural and functional abnormalities in affected tissues and organs. Radiation proctitis is a potential complication following pelvic radiation therapy. We report our experience with the use of hyperbaric oxygen treatment (HBO) for chronic radiation proctitis cases resistant to conventional treatments.

METHODS

During the period November 2001 to December 2005, 29 patients with chronic radiation proctitis, who failed to respond to oral and/or topical conventional treatments, were referred to the Department of Underwater and Hyperbaric Medicine, Istanbul Faculty of Medicine (16 females and 13 males; mean age 65). The clinical data were extracted from the medical records and the characteristics of the patient cohort, medical history, tobacco and alcohol use, diagnosis, previous medical therapies, outcome of HBO were detected.

RESULTS

In the 88% of the 18 cases who completed planned HBO, complete or partial healing was obtained. Significant improvement was observed in cases whose main complaints were bleeding, pain and diarrhea. Tenesmus and incontinence, which affects the quality of life were also decreased.

CONCLUSION

Although prospective, randomized, controlled clinical trials are still absent, avaliable retrospective studies, case reports and the present study emphasize that HBO can effectively be used for the treatment of radiation proctitis.

Keywords: Hyperbaric oxygen, treatment; radiation injuries; proctitis; rectal bleeding; hyperbaric oxygenation