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Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury
Article first published online: 2 DEC 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 15, pages 3860–3868, 1 August 2012
How to Cite
Hampson, N. B., Holm, J. R., Wreford-Brown, C. E. and Feldmeier, J. (2012), Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury. Cancer, 118: 3860–3868. doi: 10.1002/cncr.26637
- Issue published online: 20 JUL 2012
- Article first published online: 2 DEC 2011
- Manuscript Accepted: 23 SEP 2011
- Manuscript Revised: 22 SEP 2011
- Manuscript Received: 13 AUG 2011
Although hyperbaric oxygen is used to treat chronic radiation tissue injury, clinical evidence supporting its efficacy has been limited to date. The authors report prospectively collected patient outcomes from a single center's large experience using hyperbaric oxygen to treat chronic radiation injury.
Since 2002, patient outcomes at the conclusion of a course of hyperbaric oxygen treatment for chronic radiation tissue injury at Virginia Mason Medical Center in Seattle have been graded by a board-certified hyperbaric physician and prospectively recorded. From 2002 to 2010, a total of 525 patients received treatment for 1 of 6 forms of radionecrosis analyzed. After excluding 114 patients for incomplete records or treatment courses or for previous receipt of hyperbaric oxygen therapy, records of 411 patients were retrospectively reviewed in 2010, and outcomes were regraded by a second board-certified physician. A positive clinical response was defined as an outcome graded as either “resolved” (90%-100% improved) or “significantly improved” (50%-89% improved).
A positive outcome from hyperbaric treatment occurred in 94% of patients with osteoradionecrosis of the jaw (n = 43), 76% of patients with cutaneous radionecrosis that caused open wounds (n = 58), 82% of patients with laryngeal radionecrosis (n = 27), 89% of patients with radiation cystitis (n = 44), 63% of patients with gastrointestinal radionecrosis (n = 73), and 100% of patients who were treated in conjunction with oral surgery in a previously irradiated jaw (n = 166).
The outcomes of 411 patients collected prospectively over 8 years strongly supported the efficacy of hyperbaric oxygen treatment for the 6 conditions evaluated. The response rates previously reported in numerous small series were supported by the responses achieved in this large, single-center experience. Cancer 2012. © 2011 American Cancer Society.