Last Updated: 2006-07-12 15:51:24 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Treatment with hyperbaric oxygen may improve the severe proctitis that can occur as a result of radiotherapy for prostate cancer, according to a report in the Journal of Urology for July.
Although proctitis is a common problem following external beam radiotherapy or brachytherapy for prostate cancer, only 5% of patients develop disease that is refractory to conservative treatment. Dr. John M. Corman, from Virginia Mason Medical Center in Seattle, and colleagues describe the outcomes of 27 such patients who were treated with hyperbaric oxygen, a modality that has proven useful in treating chronic wounds.
Sixteen of the men developed proctitis after receiving external beam radiotherapy, 4 after receiving brachytherapy, and 7 after receiving both modalities, the report indicates. In all of the cases, the proctitis was not responsive to medical treatment or endoscopic management.
With hyperbaric oxygen therapy, the subjects were exposed to 100% oxygen at a pressure of 2.4 atmospheres absolute for 90 minutes at least 5 days a week. On average, the patients completed 36 sessions.
Of the 25 patients with bleeding, 12 experienced complete resolution with hyperbaric oxygen, 7 improved, 5 were unchanged, and data were lacking for 1 patient.
Fecal urgency, a problem for 4 patients, resolved with hyperbaric oxygen in 2, improved in 1, and no data were available for the other.
While none of the 8 patients with pain experienced resolution of this symptom with hyperbaric oxygen, 6 improved, 1 was unchanged, and data were unavailable for 1.
Fourteen patients had rectal ulceration, but hyperbaric oxygen provided resolution in only 2. Five patients experienced an improvement, 6 were unchanged, and data were unavailable for 1.
In the overall analysis, about one third of patients each were classified as having a good, partial or no response to hyperbaric oxygen, the authors note.
"This series of patients showed a good overall response rate to hyperbaric oxygen for radiation induced proctopathy after other attempts at management had failed," the authors note. "Hyperbaric oxygen is generally well tolerated and it remains an important treatment option for managing this common and difficult disease."
J Urol 2006;176:87-90.
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