Hyperbaric oxygen - an effective tool to treat radiation morbidity in prostate cancer

Purpose: We report the results of hyperbaric oxygen therapy (HBO) used in t he treatment of radiation cystitis and proctitis following irradiation of p rostate cancer. Materials and Methods: Between June 1995 and March 2000, 18 men (median age 71 years) with radiation proctitis (n = 7), cystitis (n = 8), and combined proctitis/cystitis (n = 3) underwent HBO therapy in a multiplace chamber f or a median of 26 sessions (range 2-60). The treatment schedule (2.2-2.4 at mospheres absolute, 60 min bottom time, once-a-day, 7 days a week) was set at a lower limit of 20 sessions; the upper limit was left open to symptom-r elated adjustment. Prior to HBO treatment, RTOG/EORTC late genitourinal (GU ) morbidity was Grade 2 (n = 3), Grade 3 (n = 6) or Grade 4 (n = 2); modifi ed RTOG/EORTC late gastrointestinal (GI) morbidity was either Grade 2 (n = 4) or Grade 3 (n = 6). Results: Sixteen patients underwent an adequate number of sessions. RTOG/EO RTC late GU as well as modified GI morbidity scores showed a significant im provement after HBO (GI, P = 0.004; GU, P = 0.004; exact Wilcoxon signed ra nk test); bleeding ceased in five out of five patients with proctitis and i n six out of eight patients with cystitis; one of those two patients, in wh om an ineffective treatment outcome was obtained, went on to have a cystect omy. Conclusions: HBO treatment seems to be an effective tool to treat those pat ients with late GI and GU morbidity when conventional treatment has led to unsatisfactory results. Particularly in patients with radiation cystitis, H BO should not be delayed too long, as in the case of extensive bladder shri nkage improvement is hard to achieve. (C) 2001 Elsevier Science Ireland Ltd . All rights reserved.