Hyperbaric oxygen therapy for radiation-induced tissue injury following sarcoma treatment: A retrospective analysis of a Dutch cohort

Abstract

Background and objectives Sarcomas are commonly managed by surgical resection combined with radiotherapy. Sarcoma treatment is frequently complicated by chronic wounds and late radiation tissue injury (LRTI). This study aims to gain insight in the use and results of hyperbaric oxygen therapy (HBOT) for radiation-induced complications following sarcoma treatment. Methods All sarcoma patients treated between 2006 and 2017 in one of the five centers of the Institute for Hyperbaric Oxygen in the Netherlands were included for retrospective analysis. Results Thirty patients were included, 18 (60.0%) patients were treated for chronic wounds and 12 (40.0%) for LRTI. Two patients with chronic wounds were excluded from analysis as HBOT was discontinued within five sessions. In 11 of 16 (68.8%) patients treated for chronic wounds, improved wound healing was seen. Nine of 12 (75.0%) patients treated for LRTI reported a decline in pain. Reduction of fibrosis was seen in five of eight patients (62.5%) treated for LRTI. Conclusions HBOT is safe and beneficial for treating chronic wounds and LRTI in the sarcoma population. Awaiting further prospective results, we recommend referring to HBOT centers more actively in patients experiencing impaired wound healing or symptoms of delayed radiationinduced tissue injury following multimodality sarcoma treatment.

Construction and validation of checklist for referral to the hyperbaric oxygen therapy unit

“…O relato de claustrofobia está presente no tratamento com OHB, no entanto, menos de 1% dos pacientes na clínica diária são afetados (SBMH, 2019). Estudo aponta que 11,1% de ocorrências são relacionadas a claustrofobia como evento adverso em OHB (Generaal et al, 2020). Em contrapartida, outro estudo registrou o percentual de 0,3% de reações claustrofóbicas, e compara-os com relatórios anteriores que chegaram a 4% dessas reações, enfatizando que alguns sintomas como: tontura, fraqueza, dor no peito e dispneias estão relacionados à ansiedade (Heyboer et al, 2017).…”

Use of hyperbaric oxygen therapy in the treatment of osteoradionecrosis of the maxilla in patients with head and neck cancer

“…However, this therapy is not totally innocuous and has significant issues for the patient, among them, the limitation of its access, and with that, the cost for oxygen therapy is very high. Furthermore, there are side effects presented in some patients, such as middle ear barotrauma due to the difference in ambient pressure, temporary worsening of myopia, and it is not indicated for patients who have claustrophobia, chronic obstructive pulmonary disease, or chronic heart failure (Generaal et al, 2020).…”

Therapeutic effects of hyperbaric oxygen

“…It can also have therapeutic importance in wounds from burns and diabetic ulcers. 34 35 36 It has a positive role in compromised flaps and can increase the effective size of composite graft survival, and improve prognosis of flap survival. Generally the skin grafts contain different tissue types with varying sizes that lack proper blood supply and are depended on the host for nutrient.…”