Hyperbaric oxygen treatment in radiation-induced cystitis and proctitis: a prospective cohort study on patient-perceived quality of recovery

Int J Radiat Oncol Biol Phys. 2013 Nov 15;87(4):670-5. doi: 10.1016/j.ijrobp.2013.07.039. Epub 2013 Sep 11.


Purpose: In this prospective cohort study, the effects of hyperbaric oxygen treatment (HBOT) were evaluated concerning patient-perceived symptoms of late radiation-induced cystitis and proctitis secondary to radiation therapy for pelvic cancer.

Methods and materials: Thirty-nine patients, 35 men and 4 women with a mean age of 71 (range, 35-84) years were included after informed consent and institutional ethics approval. They had all been treated with radiation therapy for prostate (n=34), cervix (n=2), or rectal (n=3) cancer using external beam radiation at a dose of 25 to 75 Gy. Patients with hematuria requiring blood transfusion were excluded. The HBOT was delivered with 100% oxygen for 90 minutes at 2.0 to 2.4 atmospheres (ATA). Mean number of treatments was 36 (28-40). Symptoms were prospectively assessed using the Expanded Prostate Index Composite score before, during, and 6 to 12 months after HBOT.

Results: The HBOT was successfully conducted, and symptoms were alleviated in 76% for patients with radiation cystitis, 89% for patients with radiation proctitis, and 88% of patients with combined cystitis and proctitis. Symptom reduction was demonstrated by an increased Expanded Prostate Index Composite score in the urinary domain from 50±16 to 66±20 after treatment (P<.001) and in the bowel domain from 48±18 to 68±18 after treatment (P<.001). For 31% of the patients with cystitis and 22% with proctitis, there were only trivial symptoms after HBOT. The improvement was sustained at follow-up in both domains 6 to 12 months after HBOT. No severe side effects were observed related to HBOT, and treatment compliance was high.

Conclusions: HBOT can be an effective and safe treatment modality for late radiation therapy-induced soft tissue injuries in the pelvic region.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Cystitis / etiology
  • Cystitis / therapy*
  • Diagnostic Self Evaluation*
  • Female
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data
  • Proctitis / etiology
  • Proctitis / therapy*
  • Prospective Studies
  • Prostatic Neoplasms / radiotherapy
  • Radiation Injuries / complications
  • Radiation Injuries / therapy*
  • Radiotherapy Dosage
  • Recovery of Function*
  • Rectal Neoplasms / radiotherapy
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / radiotherapy