Treatment of radiation proctitis with hyperbaric oxygen.
OBJECTIVE
Radiation proctitis is a potential complication following pelvic radiation therapy. There are no standard treatments and treatment outcomes are unpredictable. We report our experience with the use of hyperbaric oxygen treatment (HBOT) for radiation proctitis cases refractory to standard medical or laser therapy.


METHODS
During the period 2000-2004, 10 patients with radiation proctitis were treated with HBOT (three males and seven females; mean age of 65). The median follow-up period was 25 months (range 6-43 months). Patient symptoms were retrospectively scored prior to, and following HBOT, based on the LENT-SOMA scale.


RESULTS
Prior to treatment, three patients had Grade 3 toxicity (i.e. requiring blood transfusions) and seven had Grade 2 toxicity with dominant symptoms of rectal pain and/or diarrhoea. HBOT was well tolerated and 9 of the 10 patients completed a full HBOT treatment program. Rectal bleeding completely stopped in four of nine symptomatic patients and improved in three others. Rectal pain completely remitted in three of five symptomatic patients. Diarrhea remitted completely in one of five patients and improved in three others. Of the 10 patients treated, only two did not respond to HBOT.


CONCLUSIONS
Significant improvement of rectal bleeding, diarrhea and rectal pain is possible using HBOT. HBOT should be offered to patients who fail conventional treatments for radiation proctitis.
Jones
Kurian
K
Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, Ont., Canada.
Evans
A Wayne
AW
Bristow
Robert G
RG
Levin
Wilfred
W
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000528:radiation effects*; D011349:Proctitis / Q000209:etiology / Q000628:therapy*; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D012007:Rectum / Q000528:radiation effects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014565:Urogenital Neoplasms / Q000532:radiotherapy*