Radiation Wounds

We have had good success with the following diagnoses:

• Hemorrhagic cystitis (bleeding from the bladder due to radiation)
• Hemorrhagic enteritis (small bowel)
• Hemorrhagic proctitis (last part of the large bowel)
• Soft tissue radionecrosis
• Skin wounds due to radiation.    There may be healing problems after surgery in an area that has been previously irradiated (such as prior breast irradiation).  Hyperbaric oxygen therapy may minimize this problem preoperatively or postoperatively.

Int J Radiat Oncol Biol Phys. 2004 Nov 1;60(3):871-8.  

The efficacy of hyperbaric oxygen therapy in the treatment of radiation-induced late side effects.

Bui QC, Lieber M, Withers HR, Corson K, van Rijnsoever M, Elsaleh H.

Department of Radiation Oncology, David Geffen School of Medicine at UCLA, 200 Medical Plaza B265, Los Angeles, CA 90095-6951, USA.

PURPOSE: We investigated the efficacy of hyperbaric oxygen therapy (HBOT) in the management of patients with radiation-induced late side effects, the majority of whom had failed previous interventions. METHODS AND MATERIALS: Of 105 eligible subjects, 30 had either died or were not contactable, leaving 75 who qualified for inclusion in this retrospective study. Patients answered a questionnaire documenting symptom severity before and after treatment (using Radiation Therapy Oncology Group criteria), duration of improvement, relapse incidence, and HBOT-related complications. RESULTS: The rate of participation was 60% (45/75). Improvement of principal presenting symptoms after HBOT was noted in 75% of head-and-neck, 100% of pelvic, and 57% of "other" subjects (median duration of response of 62, 72, and 68 weeks, respectively). Bone and bladder symptoms were most likely to benefit from HBOT (response rate, 81% and 83%, respectively). Fifty percent of subjects with soft tissue necrosis/mucous membrane side effects improved with HBOT. The low response rate of salivary (11%), neurologic (17%), laryngeal (17%), and upper gastrointestinal symptoms (22%) indicates that these were more resistant to HBOT. Relapse incidence was low (22%), and minor HBOT-related complications occurred in 31% of patients. CONCLUSION: Hyperbaric oxygen therapy is a safe and effective treatment modality offering durable relief in the management of radiation-induced osteoradionecrosis either alone or as an adjunctive treatment. Radiation soft tissue necrosis, cystitis, and proctitis also seemed to benefit from HBOT, but the present study did not have sufficient numbers to reliably predict long-term response.

PMID: 15465205 [PubMed - indexed for MEDLINE]