Contribution of hyperbaric oxygen in irradiation-induced digestive disorders: 36 observations

OBJECTIVES: Study the effect of hyperbaric oxygen on chronic irradiation-in duced digestive disorders. PATIENTS AND METHODS: A retrospective study was conducted in 36 patients (m ean age 66 +/- 11 years) with chronic digestive tract necrosis which had de veloped a mean 42 months after irradiation therapy. Hyperbaric oxygen thera py was given a mean 17 months after symptom onset: failing healing (n = 9), rectal bleeding (n = 19), profuse diarrhea (n = 9), recurrent anal abscess (n = 1). The severity of the digestive tract radionecrosis was quantified using the Soma-Lent scale. Hyperbaric oxygen therapy was grade 1 (n = 1), g rade 2 (n = 11), grade 3 (n = 16), grade 4 (n = 8). RESULTS: Thirty-six patients underwent a mean 67 hyperbaric sessions (100% O-2, 2.5 aim, 90 min). Three patients died within one month of the first se ssion due to radiation enteritis, a neoplastic process or another concomita nt cause, immediate outcome after hyperparic oxygen therapy was cure (n = 3 )or improvement (n = 16) in 19 patients (53%) and failure in 17(47%). Long- term results evaluated in 32 subjects with a mean 52 months follow-up were: cure (n = 9) or improvement (n = 12) in 21 patients (66%) and failure in 1 1 (34%). Nine patients died within a mean 25 months after the end of the hy perbaric sessions. Death was related to digestive tract radionecrosis in 1 case and neoplasia in 5. CONCLUSION: Hyperbaric-oxygen therapy provides clinical relief in 2 out of 3 patients and can be a useful alternative to conventional treatment in pat ients with chronic radiation-induced necrosis of the digestive tract.