[The role of hyperbaric oxygen therapy in radiation-induced digestive disorders. 36 cases].
OBJECTIVE
Study the effect of hyperbaric oxygen on chronic irradiation induced digestive disorders.


METHODS
A retrospective study was conducted in 36 patients (mean age 66 +/- 11 years) with chronic digestive tract necrosis which had developed a mean 42 months after irradiation therapy. Hyperbaric oxygen therapy was given a mean 17 months after symptom onset: failing healing (n = 9), rectal bleeding (n = 19), profuse diarrhea (n = 9), recurrent anal abscess (n = 1). The severity of the digestive tract radionecrosis was quantified using the Soma-Lent scale. Hyperbaric oxygen therapy was grade 1 (n = 1), grade 2 (n = 11), grade 3 (n = 16), grade 4 (n = 8).


RESULTS
Thirty-six patients underwent a mean 67 hyperbaric sessions (100% O2, 2.5 atm, 90 min). Three patients died within one month of the first session due to radiation enteritis, a neoplastic process or another concomitant cause. Immediate outcome after hyperbaric oxygen therapy was cure (n = 3) or improvement (n = 16) in 19 patients (53%) and failure in 17 (47%). Long-term results evaluated in 32 subjects with a mean 52 months follow-up were: cure (n = 9) or improvement (n = 12) in 21 patients (66%) and failure in 11 (34%). Nine patients died within a mean 25 months after the end of the hyperbaric sessions. Death was related to digestive tract radionecrosis in 1 case and neoplasia in 5.


CONCLUSIONS
Hyperbaric oxygen therapy provides clinical relief in 2 out of 3 patients and can be a useful alternative to conventional treatment in patients with chronic radiation-induced necrosis of the digestive tract.
Service de Réanimation Médicale et Unité de Médecine Hyperbare, Angers. Reamed@chu.angers.fr
J P
JP
Gouëllo
G
G
Bouachour
B
B
Person
J
J
Ronceray
P
P
Cellier
P
P
Alquier
D000368:Aged; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D011832:Radiation Injuries / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects
Intérêt de l'oxygènothérapie hyperbare dans la pathologie digestive post-radique. 36 observations.