title: Effect of prophylactic hyperbaric oxygen treatment for radiation-induced brain injury after stereotactic radiosurgery of brain metastases.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the prophylactic effect of hyperbaric oxygen (HBO) therapy for radiation-induced brain injury in patients with brain metastasis treated with stereotactic radiosurgery (SRS).
  
  
  METHODS
  The data of 78 patients presenting with 101 brain metastases treated with SRS between October 1994 and September 2003 were retrospectively analyzed. A total of 32 patients with 47 brain metastases were treated with prophylactic HBO (HBO group), which included all 21 patients who underwent subsequent or prior radiotherapy and 11 patients with common predictors of longer survival, such as inactive extracranial tumors and younger age. The other 46 patients with 54 brain metastases did not undergo HBO (non-HBO group). The radiation-induced brain injuries were divided into two categories, white matter injury (WMI) and radiation necrosis (RN), on the basis of imaging findings.
  
  
  RESULTS
  The radiation-induced brain injury occurred in 5 lesions (11%) in the HBO group (2 WMIs and 3 RNs) and in 11 (20%) in the non-HBO group (9 WMIs and 2 RNs). The WMI was less frequent for the HBO group than for the non-HBO group (p = 0.05), although multivariate analysis by logistic regression showed that WMI was not significantly correlated with HBO (p = 0.07). The 1-year actuarial probability of WMI was significantly better for the HBO group (2%) than for the non-HBO group (36%) (p < 0.05).
  
  
  CONCLUSIONS
  The present study showed a potential value of prophylactic HBO for the radiation-induced WMIs, which justifies further evaluation to confirm its definite benefit.
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, Iseigaoka, Kitakyushu, Japan. ogurieye@med.uoeh-u.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohguri
authors.forename: Hajime
authors.initials: H
authors.lastname: Imada
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kohshi
authors.forename: Shingo
authors.initials: S
authors.lastname: Kakeda
authors.forename: Norihiro
authors.initials: N
authors.lastname: Ohnari
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Morioka
authors.forename: Keita
authors.initials: K
authors.lastname: Nakano
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Konda
authors.forename: Yukunori
authors.initials: Y
authors.lastname: Korogi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology / Q000517:prevention & control; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies