THE TREATMENT OF LATE RADIATION EFFECTS WITH HYPERBARIC OXYGENATION (HBO)

Background: Late radiation injuries may impose a negative influence on the quality of life in the affected patients. In several entities, st andardized treatment protocols are lacking. Hyperbaric oxygenation (HB O) has been shown to have beneficial effects in the treatment of late radiation sequelae. Material and Methods: The basic principles of HBO are reviewed as well as clinical issues. Current study protocols are p resented. Results: During HBO-therapy the patient breathes pure oxygen at pressures above 100 kPa. The oxygen solubility within the fluid ph ase of the blood is largely increased. Biological effects include an i ncreased oxygen diffusibility, improved collagen synthesis and neoangi ogenesis as well as an enhancement of antimicrobial defenses. By decre asing the capillary filtration pressure a reduction of edema becomes p ossible. HBO has been shown to prevent complications following surgery in irradiated tissues. Its efficacy as an adjunct in the treatment of osteonecroses in radiation patients could be demonstrated. In additio n. the loss of osseointegrated implants in the maxillofacial bones of these patients could be significantly reduced. Further indications inc lude soft tissue necroses, hemorrhagic cystitis and proctitis in tumor patients that have been treated by radiotherapy as part of a multimod ality approach. Conclusions: HBO in the treatment of late radiation ef fects is still subject of investigation, but remarkable results have b een reported. Optimized treatment protocols need to be determined in v arious entities. The rate of side effects is acceptable low.