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HBO Therapy in the Management of Radionecrosis

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Textbook of Hyperbaric Medicine
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Abstract

Hyperbaric oxygen (HBO) therapy has been used with good results in the management of radionecrosis—the term used for radiation-induced tissue necrosis. This chapter reports on the applications after discussing important background topics such as physics, biology, and pathology. HBO therapy for radionecrosis is considered according to involvement of various types of tissues such as soft tissues and bones (osteoradionecrosis). Special consideration is given management of radionecrosis of the central nervous system (CNS). Because radiation therapy is used for treatment of cancer, the effect of HBO on cancer recurrence is also discussed.

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References

  • Abe M, Shioyama Y, Terashima K, Matsuo M, Hara I, Uehara S. Successful hyperbaric oxygen therapy for laryngeal radionecrosis after chemoradiotherapy for mesopharyngeal cancer: case report and literature review. Jpn J Radiol. 2012;30:340–4.

    Article  PubMed  Google Scholar 

  • Ahlbom HE. Results of radiotherapy of hypopharyngeal cancer at Radium-hemmet, Stockholm. Acta Radiol. 1941;22:155–71.

    Article  Google Scholar 

  • Angibaud G, Ducasse JL, Baille G, Clanet M. Potential value of hyperbaric oxygenation in the treatment of post-radiation myelopathies. Rev Neurol (Paris). 1995;151:661–6.

    CAS  Google Scholar 

  • Ashamalla HL, Thom SR, Goldwein JW. Hyperbaric oxygen therapy for the treatment of radiation-induced sequelae in children. The University of Pennsylvania experience. Cancer. 1996;77:2407–12.

    Article  PubMed  CAS  Google Scholar 

  • Bennett MH, Feldmeier J, Hampson NB, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Syst Rev. 2016;4, CD005005.

    PubMed  Google Scholar 

  • Borruat FX, Schatz NJ, Glass JS, Feun LG, Matos L. Visual recovery from radiation-induced optic neuropathy: role of hyperbaric oxygenation. J Clin Neuroophthalmology. 1993;13:98–101.

    CAS  Google Scholar 

  • Boschetti M, De Lucchi M, Giusti M, Spena C, Corallo G, Goglia U, et al. Partial visual recovery from radiation-induced optic neuropathy after hyperbaric oxygen therapy in a patient with Cushing disease. Eur J Endocrinol. 2006;154:813–8.

    Article  PubMed  CAS  Google Scholar 

  • Calabro F, Jinkins JR. MRI of radiation myelitis: a report of a case treated with hyperbaric oxygen. Eur Radiol. 2000;10:1079–84.

    Article  PubMed  CAS  Google Scholar 

  • Charneau J, Bouachour G, Person B, Burtin P, Ronceray J, Boyer J. Severe hemorrhagic radiation proctitis advancing to gradual cessation with hyperbaric oxygen. Dig Dis Sci. 1991;36:373–5.

    Article  PubMed  CAS  Google Scholar 

  • Chuba PJ, Aronin P, Bhambhani K, Eichenhorn M, Zamarano L, Cianci P, et al. Hyperbaric oxygen therapy for radiation-induced brain injury in children. Cancer. 1997;80:2005–12.

    Article  PubMed  CAS  Google Scholar 

  • Ehler WJ, Marx RE, Kiel J, et al. Induced regression of oral carcinoma by oxygen radical generating systems. J Hyperbaric Med. 1991;6:111–8.

    Google Scholar 

  • Eltorai IM, Hart GB, Strauss MB, et al. Does hyperbaric oxygen provoke occult carcinoma in man? In: Kindwall EP, editor. Proceedings of the 8th International congress on hyperbaric medicine. San Pedro: Best Publishing; 1987. p. 18–29.

    Google Scholar 

  • Epstein J, van der Meij E, McKenzie M, Lepawsky M, Stevenson-Moore P. Postradiation osteonecrosis of the mandible: a long-term follow-up study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83:657–62.

    Article  PubMed  CAS  Google Scholar 

  • Fattore L, Strauss RA. Hyperbaric oxygen in the treatment of osteoradionecrosis: a review of its use and efficacy. Oral Surg Oral Med Oral Pathol. 1987;63:280–6.

    Article  PubMed  CAS  Google Scholar 

  • Feldmeier JJ. Hyperbaric oxygen therapy and delayed radiation injuries (soft tissue and bony necrosis): 2012 update. Undersea Hyperb Med. 2012;39:1121–39.

    PubMed  Google Scholar 

  • Feldmeier JJ, Hampson NB. A systematic review of the literature reporting the application of hyperbaric oxygen prevention and treatment of delayed radiation injuries: an evidence based approach. Undersea Hyperb Med. 2002;29:4–30.

    PubMed  CAS  Google Scholar 

  • Feldmeier JJ, Lange JD, Cox SD, et al. Hyperbaric oxygen as a prophylactic or treatment for radiation myelitis. Undersea Hyperbaric Med. 1993;20:249–55.

    CAS  Google Scholar 

  • Feldmeier JJ, Heimbach RD, Davolt DA, Brakora MJ. Hyperbaric oxygen as an adjunctive treatment for severe laryngeal necrosis: a report of nine consecutive cases. Undersea Hyperbaric Med. 1993a;20:329–35.

    CAS  Google Scholar 

  • Feldmeier JJ, Heimbach RD, Davolt DA, Brakora MJ. Hyperbaric oxygen and the cancer patient: a survey of practice patterns. Undersea Hyperbaric Med. 1993b;20:337–45.

    CAS  Google Scholar 

  • Feldmeier JJ, Heimbach RD, Davolt DA, Brakora MJ, Sheffield PJ, Porter AT. Does hyperbaric oxygen have a cancer-causing or -promoting effect? A review of the pertinent literature. Undersea Hyperbaric Med. 1994;21:467–75.

    CAS  Google Scholar 

  • Feldmeier JJ, Heimbach RD, Davolt DA, Court WS, Stegmann BJ, Sheffield PJ. Hyperbaric oxygen as an adjunctive treatment for delayed radiation injuries of the abdomen and pelvis. Undersea Hyperbaric Med. 1996;23:205–13.

    CAS  Google Scholar 

  • Feldmeier JJ, Heimbach RD, Davolt DA, et al. Hyperbaric oxygen as an adjunct in the treatment of delayed radiation injuries of the extremities. Undersea Hyperbaric Med. 1998;25:9 (abstract).

    Google Scholar 

  • Ferguson BJ, Hudson WR, Farmer JC. Hyperbaric oxygen therapy for laryngeal radionecrosis. Ann Otol Rhinol Larnygol. 1987;96:1–6.

    Article  CAS  Google Scholar 

  • Glassburn JR, Brady LW, Plenk HP. Hyperbaric oxygen in radiation therapy. Ann Cancer. 1977;39:751–65.

    Article  CAS  Google Scholar 

  • Greenwood TW, Gilchrist AG. Hyperbaric oxygen and wound healing in postirradiation head and neck surgery. Br J Surg. 1973;50:394.

    Google Scholar 

  • Gupta P, Sahni T, Jadhav GK, Manocha S, Aggarwal S, Verma S. A retrospective study of outcomes in subjects of head and neck cancer treated with hyperbaric oxygen therapy for radiation induced osteoradionecrosis of mandible at a tertiary care centre: an Indian experience. Indian J Otolaryngol Head Neck Surg. 2013;65 Suppl 1:140–3.

    PubMed  PubMed Central  Google Scholar 

  • Hamour A, Denning DW. Hyperbaric oxygen therapy in a women who declined colostomy. Lancet. 1996;348:197.

    Article  PubMed  CAS  Google Scholar 

  • Hampson NB, Holm JR, Wreford-Brown CE, Feldmeier J. Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury. Cancer. 2012;118:3860–8.

    Article  PubMed  CAS  Google Scholar 

  • Harding SA, Hodder SC, Courtney DJ, Bryson PJ. Impact of perioperative hyperbaric oxygen therapy on the quality of life of maxillofacial patients who undergo surgery in irradiated fields. Int J Oral Maxillofac Surg. 2008;37:617–24.

    Article  PubMed  CAS  Google Scholar 

  • Hart GB, Strauss MB. Hyperbaric oxygen in the management of radiation injury. In: Schmutz J, editor. Proceedings 1st Swiss symposium on hyperbaric medicine. Basel: Stiftung fĂĽr Hyperbare Medizin; 1986. p. 31–51.

    Google Scholar 

  • Headley DB, Gapany M, Dawson DE, Kruse GD, Robinson RA, McCabe BF. The effect of hyperbaric oxygen on growth of human squamous cell carcinoma xenografts. Arch Otolarngol Head Neck Surg. 1991;117:1269–72.

    Article  CAS  Google Scholar 

  • Hsu YC, Lee KW, Ho KY, Tsai KB, Kuo WR, Wang LF, et al. Treatment of laryngeal radionecrosis with hyperbaric oxygen therapy: a case report. Kaohsiung J Med Sci. 2005;21:88–92.

    Article  PubMed  Google Scholar 

  • Kaufman T, Hirshowitz B, Monies-Chass I. Hyperbaric oxygen for postirradiation osteomyelitis of the chest wall. Harefuah. 1979;97:220–2. 271.

    PubMed  CAS  Google Scholar 

  • Kindwall EP. Hyperbaric oxygen treatment of radiation cystitis. Clin Plast Surg. 1993;20:589–92.

    Article  PubMed  CAS  Google Scholar 

  • Kohshi K, Imada H, Nomoto S, Yamaguchi R, Abe H, Yamamoto H. Successful treatment of radiation-induced brain necrosis by hyperbaric oxygen therapy. J Neurol Sci. 2003;209:115–7.

    Article  PubMed  Google Scholar 

  • Larsen PE, Stronczek MJ, Beck FM, et al. Osteointegration of implants in radiated bones with and without adjunctive hyperbaric oxygen. J Oral Maxillofac Surg. 1993;51:280–7.

    Google Scholar 

  • Leber KA, Eder HG, Kovac H, Anegg U, Pendl G. Treatment of cerebral radionecrosis by hyperbaric oxygen therapy. Stereotact Funct Neurosurg. 1998;70 Suppl 1:229–36.

    Article  PubMed  Google Scholar 

  • Li CQ, Gerson S, Snyder B. Case report: hyperbaric oxygen and MRI findings in radiation-induced optic neuropathy. Undersea Hyperb Med. 2014;41:59–63.

    PubMed  Google Scholar 

  • Liu JL. Clinical analysis of radiation optic neuropathy. Chung Hua Yen Ko Tsa Chih. 1992;28:86–8.

    CAS  Google Scholar 

  • McMillan T, Calhoun KH, Mader JT, et al. The effect of hyperbaric oxygen on oral mucosal carcinoma. Laryngoscope. 1989;99:241–4.

    Article  PubMed  CAS  Google Scholar 

  • Mainous EG, Boyne PJ, Hart GB. Hyperbaric oxygen treatment of mandibular osteomyelitis: report of three cases. J Am Dent Assoc. 1973;87:1426–30.

    Article  PubMed  CAS  Google Scholar 

  • Marx RE, Johnson RP. Problem wounds in oral and maxillofacial surgery: the role of hyperbaric oxygen. In: Davis JC, Hunt TK, editors. Problem wounds, the role of oxygen. New York: Elsevier; 1988. p. 65–123.

    Google Scholar 

  • Marx RE, Johnson RP, Kline SN. Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin. J Am Dent Assoc. 1985;111:49–54.

    Article  PubMed  CAS  Google Scholar 

  • Mestrovic J. Does hyperbaric oxygen have a cancer-causing or promoting effect? Undersea Hyperbaric Med 1996;23: 55–56 (letter).

    Google Scholar 

  • Mestrovic J, Kosuta D, Gosovic S, Denoble P, Radojković M, Angjelinović S, et al. Suppression of rat tumour colonies in the lung by oxygen at high pressure is a local effect. Clin Exp Metastasis. 1996;8:113–9.

    Article  Google Scholar 

  • Morita T, Takahashi K, Kitani Y, et al. Treatment of radiation cystitis with hyperbaric oxygen. In: Proceedings of the XI International Congress on Hyperbaric Medicine. San Pedro, Best Publishing; 1994.

    Google Scholar 

  • Mounsey RA, Brown DH, O’Dwyer TP, Gullane PJ, Koch GH. Role of oxygen therapy in the management of mandibular osteoradionecrosis. Laryngoscope. 1993;103:605–8.

    Article  PubMed  CAS  Google Scholar 

  • Nakada T, Yamaguchi T, Sasagawa I, Kubota Y, Suzuki H, Izumiya K. Successful hyperbaric oxygenation for radiation cystitis due to excessive irradiation to uterus cancer. Eur Urol. 1992;22:294–8.

    Article  PubMed  CAS  Google Scholar 

  • Neovius EB, Lind MG, Lind FG. Hyperbaric oxygen therapy for wound complications after surgery in the irradiated head, and neck: a review of the literature and a report of 15 consecutive patients. Head Neck. 1997;19:315–22.

    Article  PubMed  CAS  Google Scholar 

  • Narozny W, Sicko Z, Kot J, Stankiewicz C, Przewozny T, Kuczkowski J. Hyperbaric oxygen therapy in the treatment of complications of irradiation in head and neck area. Undersea Hyperb Med. 2005;32:103–10.

    PubMed  CAS  Google Scholar 

  • Neurath MF, Branbrink A, Meyer zum BĂĽschenfelde KH, Lohse AW. A new treatment for severe malabsorption due to radiation enteritis. Lancet 1996;347: 1302.

  • Niezgoda JA, Serena TE, Carter MJ. Outcomes of radiation injuries using hyperbaric oxygen therapy: an observational cohort study. Adv Skin Wound Care. 2016;29:12–9.

    Article  PubMed  Google Scholar 

  • Norkool DM, Hampson NB, Gibbons RP, Weissman RM. Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis. J Urology. 1993;150:332–4.

    Article  CAS  Google Scholar 

  • Oliai C, Fisher B, Jani A, Wong M, Poli J, Brady LW, et al. Hyperbaric oxygen therapy for radiation-induced cystitis and proctitis. Int J Radiat Oncol Biol Phys. 2012;84:733–40.

    Article  PubMed  CAS  Google Scholar 

  • Patel P, Raybould T, Maryama Y. Osteoradionecrosis of the jaw bones at the University of Kentucky Medical Center. J Kentucky Med Assoc. 1989;87:327–31.

    CAS  Google Scholar 

  • Poulton TJ, Witcofski RL. Hyperbaric oxygen therapy for radiation myelitis. Undersea Biomed Res. 1985;12:453–8.

    PubMed  CAS  Google Scholar 

  • Ramsden RT, Bulman CH, Lorigan BP. Osteoradionecrosis of the temporal bone. Otolaryngol Head Neck Surg. 1975;89:941–55.

    CAS  Google Scholar 

  • Ribeiro de Oliveira TM, Carmelo RomĂŁo AJ, Gamito Guerreiro FM, Matos Lopes TM. Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis. Int J Urol. 2015;22:962–6.

    Article  PubMed  CAS  Google Scholar 

  • Rijkmans BG, Bakker DJ, Dabhoiwala NF, Kurth KH. Successful treatment of radiation cystitis with hypealianic oxygenation. Eur Urol. 1989;16:354–6.

    Article  PubMed  CAS  Google Scholar 

  • Roden D, Bostley TM, Fowble B, Clark J, Savino PJ, Sergott RC, et al. Delayed radiation injury to the retrobulbar optic nerves and chiasm. Ophthalmology. 1990;97:346–51.

    Article  PubMed  CAS  Google Scholar 

  • Rudge FW. Osteoradionecrosis of the temporal bone: treatment with hyperbaric oxygen therapy. Military Med. 1993;158:196–8.

    Article  CAS  Google Scholar 

  • Shameem IA, Shimabukuro T, Shirataki S, Yamamoto N, Maekawa T, Naito K. Hyperbaric oxygen therapy for the control of intractable cyclophosphamide-induced hemorrhagic cystitis. Eur Urol. 1992;22:263–4.

    Article  PubMed  CAS  Google Scholar 

  • Sklizovic D, Sanger J, Kindwall EP, Fink JG, Grunert BK, Campbell BH. Hyperbaric oxygen therapy and squamous cell carcinoma cell line growth. Head Neck. 1993;5:236–40.

    Article  Google Scholar 

  • Slade B, Cianci P. Outcomes in 124 patients after monoplace hyperbaric oxygen therapy for radiation tissue damage—a 14 year experience. Undersea Hyperbaric Med 1998;25: 9 (abstract).

    Google Scholar 

  • Svalestad J, Thorsen E, Vaagbø G, Hellem S. Effect of hyperbaric oxygen treatment on oxygen tension and vascular capacity in irradiated skin and mucosa. Int J Oral Maxillofac Surg. 2014;43:107–12.

    Article  PubMed  CAS  Google Scholar 

  • Torubarov FS, Pakhomov VI, Krylova IV, Agapova EV. Changes in cerebral hemodynamics in patients with vascular pathology in the late stages of radiation sickness treated with hyperbaric oxygenation. Zh Nevropatol Psikhiatr Im S S Korsakova. 1983;83(1):28–33.

    PubMed  CAS  Google Scholar 

  • ValadĂŁo J, Pearl J, Verma S, Helms A, Whelan H. Hyperbaric oxygen treatment for post-radiation central nervous system injury: a retrospective case series. Undersea Hyperb Med. 2014;41:87–96.

    PubMed  Google Scholar 

  • Velu SS, Myers RAM. Hyperbaric oxygen treatment of radiation induced hemorrhagic cystitis (abstract). Undersea Biomed Res. 1992;19(suppl):85.

    Google Scholar 

  • Wang X, Ding I, Xie H, Wu T, Wersto N, Huang K, et al. Hyperbaric oxygen and basic fibroblast growth factor promote growth of irradiated bone. Int J Radiat Oncol Biol Phys. 1998;40:189–96.

    Article  PubMed  CAS  Google Scholar 

  • Warren DC, Feehan P, Slade JB, Cianci PE. Chronic radiation proctitis treated with hyperbaric oxygen. Undersea Hyperbaric Med. 1997;24:181–4.

    CAS  Google Scholar 

  • Weiss JP, Neville EC. Hyperbaric oxygen: primary treatment of radiation-induced hemorrhagic cystitis. J Urol. 1989;142:43–5.

    Article  PubMed  CAS  Google Scholar 

  • Williams Jr JA, Clarke D, Dennis WA, Dennis 3rd EJ, Smith ST. The treatment of pelvic soft tissue radiation necrosis with hyperbaric oxygen. Am J Obstet Gynecol. 1992;167:412–5; discussion 415–6.

    Article  PubMed  Google Scholar 

  • Woo TC, Joseph D, Oxer H. Hyperbaric oxygen treatment for radiation proctitis. Int J Radiat Oncol Biol Phys. 1997;38:619–20.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to K. K. Jain MD, FRACS, FFPM .

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Jain, K.K. (2017). HBO Therapy in the Management of Radionecrosis. In: Textbook of Hyperbaric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-47140-2_17

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  • DOI: https://doi.org/10.1007/978-3-319-47140-2_17

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