title: Efficacy of hyperbaric oxygen therapy in patients with radiation-induced rectal ulcers: Report of five cases.
abstract: For decades, hyperbaric oxygen therapy has been considered a treatment option in patients with chronic radiation-induced proctitis after pelvic radiation therapy. Refractory cases of chronic radiation-induced proctitis include ulceration, stenosis, and intestinal fistulas with perforation. Appropriate treatment needs to be given. In the present study, we assessed the efficacy of hyperbaric oxygen therapy in five patients with radiation-induced rectal ulcers. Significant improvement and complete ulcer resolution were observed in all treated patients; no side-effects were reported. Hyperbaric oxygen therapy has a low toxicity profile and appears to be highly effective in patients with radiation-induced rectal ulcers. However, hyperbaric oxygen therapy alone failed to improve telangiectasia and easy bleeding in four of the five patients; these patients were further treated with argon plasma coagulation (APC). Although hyperbaric oxygen therapy may be effective in healing patients with ulcers, it seems inadequate in cases with easy bleeding. Altogether, these data suggest that combination therapy with hyperbaric oxygen therapy and APC may be an effective and safe treatment strategy in patients with radiation-induced rectal ulcers.
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Shoichi
authors.identifier: http://orcid.org/0000-0002-2936-4612
authors.initials: S
authors.lastname: Yoshimizu
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Chino
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Fuyuki
authors.initials: F
authors.lastname: Tagao
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Iwasaki
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ide
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Tamegai
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Igarashi
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Saito
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Fujisaki
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D008875:Middle Aged; D011349:Proctitis / Q000209:etiology / Q000628:therapy*; D011832:Radiation Injuries / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D012002:Rectal Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D012494:Sampling Studies; D016896:Treatment Outcome; D014456:Ulcer / Q000209:etiology / Q000473:pathology / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery
keywords: argon plasma coagulation; chronic radiation proctitis; hyperbaric oxygen therapy; radiation therapy; radiation-induced rectal ulcer