Hyperbaric oxygen therapy as a complementary treatment for radiation proctitis: Useless or useful? - A literature review

Diogo Alpuim Costa, Joana Santos Cardoso, Isabel Rosa, João Vieira Branco, Carla Espiney Amaro, Pedro Modas Daniel, Ana Nunes

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Abstract

Radiotherapy (RT) is the backbone of multimodality treatment of more than half of cancer cases. Despite new modern RT techniques, late complications may occur such as radiation proctitis (RP). The natural history of RP is unpredictable. Minor symptoms may resolve spontaneously or require conservative treatment. On the other hand, for similar and uncomplicated clinical contexts, symptoms may persist and can even be refractory to the progressive increase in treatment measures. Over the last decades, an enormous therapeutic armamentarium has been considered in RP, including hyperbaric oxygen therapy (HBOT). Currently, the evidence regarding the impact of HBOT on RP and its benefits is conflicting. Additional prospective and randomised studies are necessary to validate HBOT's effectiveness in the 'real world' clinical practice. This article reviewed the relevant literature on pathophysiology, clinical presentation, different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.

Original languageEnglish
Pages (from-to)4413-4428
Number of pages16
JournalWorld Journal of Gastroenterology
Volume27
Issue number27
DOIs
Publication statusPublished - 21 Jul 2021

Keywords

  • Delayed radiation injury
  • Hyperbaric oxygen
  • Hyperbaric oxygen therapy
  • Late radiation tissue injury
  • Late sequelae
  • Radiation proctitis
  • Radiation proctopathy
  • Radio-induced lesion
  • Radiotherapy
  • Review

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