4.6 Review

Hyperbaric oxygen therapy as a complementary treatment for radiation proctitis: Useless or useful? - A literature review

期刊

WORLD JOURNAL OF GASTROENTEROLOGY
卷 27, 期 27, 页码 4413-4428

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BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v27.i27.4413

关键词

Radiation proctitis; Radiation proctopathy; Radiotherapy; Radio-induced lesion; Late radiation tissue injury; Delayed radiation injury; Late sequelae; Hyperbaric oxygen therapy; Hyperbaric oxygen; Review

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Radiotherapy is a common treatment for cancer, but it may lead to late complications such as radiation proctitis (RP). Management of RP is challenging and may include hyperbaric oxygen therapy (HBOT), although the effectiveness of HBOT remains uncertain. More prospective and randomized studies are needed to determine the true impact of HBOT on RP treatment.
Radiotherapy (RT) is the backbone of multimodality treatment of more than half of cancer cases. Despite new modern RT techniques, late complications may occur such as radiation proctitis (RP). The natural history of RP is unpredictable. Minor symptoms may resolve spontaneously or require conservative treatment. On the other hand, for similar and uncomplicated clinical contexts, symptoms may persist and can even be refractory to the progressive increase in treatment measures. Over the last decades, an enormous therapeutic armamentarium has been considered in RP, including hyperbaric oxygen therapy (HBOT). Currently, the evidence regarding the impact of HBOT on RP and its benefits is conflicting. Additional prospective and randomised studies are necessary to validate HBOT's effectiveness in the 'real world' clinical practice. This article reviewed the relevant literature on pathophysiology, clinical presentation, different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.

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