The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study

Bibliographic Details
Main Author: Moreira Monteiro, António
Publication Date: 2023
Other Authors: Alpuim Costa, Diogo, Mareco, Virgínia, Espiney Amaro, Carla
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/157763
Summary: Funding Information: We thank Professor Elisabete Fernandes from the Faculdade de Medicina (Universidade de Lisboa) for collaborating on the statistical analysis. We also thank all the staff of the Centro de Medicina Subaquática e Hiperbárica (Armed Forces Hospital, Lisbon) for facilitating the consultation of the archived medical records. Publisher Copyright: Copyright © 2023 Moreira Monteiro, Alpuim Costa, Mareco and Espiney Amaro.
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spelling The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort studyhyperbaric oxygenhyperbaric oxygen therapyhyperbaric oxygenationlate radiation tissue injuryradiation injuryradiation proctitisradiation-induced proctitisradiotherapyOncologyCancer ResearchSDG 3 - Good Health and Well-beingFunding Information: We thank Professor Elisabete Fernandes from the Faculdade de Medicina (Universidade de Lisboa) for collaborating on the statistical analysis. We also thank all the staff of the Centro de Medicina Subaquática e Hiperbárica (Armed Forces Hospital, Lisbon) for facilitating the consultation of the archived medical records. Publisher Copyright: Copyright © 2023 Moreira Monteiro, Alpuim Costa, Mareco and Espiney Amaro.Introduction: Despite modern radiotherapy (RT) techniques, radiation-induced proctitis (RIP) remains a significant complication of RT for pelvic organ malignancies. Over the last decades, an enormous therapeutic armamentarium has been considered in RIP, including hyperbaric oxygen therapy (HBOT). However, the evidence regarding the impact of HBOT on RIP is conflicting. This study aims to evaluate the effectiveness and safety of HBOT in the treatment of RIP. Methods: Ten-year (2013-2023) retrospective analysis of all consecutive patients with RIP treated with HBOT at Centro de Medicina Subaquática e Hiperbárica (CMSH) (Armed Forces Hospital – Lisbon, Portugal). Patients were exposed to 100% oxygen at 2.5 ATA, in a multiplace first-class hyperbaric chamber, for 70-min periods, once daily, five times per week. Fisher’s exact test was performed using SPSS (version 23.0); p<0.05 was accepted as statistically significant. Results: Of a total of 151 patients with RIP, 88 were included in the final analysis, of whom 38.6% evidenced other concurrent radiation-induced soft tissue lesions. The most reported primary pelvic tumor treated with RT was prostate cancer (77.3%), followed by cervical cancer (10.2%). Hematochezia was the most observed clinical manifestation (86.4%). After a median of 60 HBOT sessions (interquartile range [IQR]: 40-87.5), 62.5% and 31.8% of patients achieved a clinical complete and partial response, respectively, with a hematochezia resolution rate of 93.7% (complete or partial). While partial and complete responses require fewer than 70 sessions of HBOT in terms of overall RIP symptoms (p=0.069), isolated hematochezia tends to require at least 70 sessions (p=0.075). Individuals with at least two concurrent late radiation tissue injuries were associated with a complete response to HBOT (p=0.029). Only about 5.7% of patients did not respond to the treatment. Eighteen patients (20.5%) developed reversible ear barotrauma. The number of HBOT sessions was a predictor of HBOT side effects (odds ratio: 1.010; 95% confidence interval, 1.000-1.020; p=0.047). Conclusion: The HBOT proved to be an effective and safe treatment for RIP refractory to medical and/or endoscopic treatments. This real-world evidence study adds value to published data on the management of RIP with HBOT.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNMoreira Monteiro, AntónioAlpuim Costa, DiogoMareco, VirgíniaEspiney Amaro, Carla2023-09-13T22:18:22Z2023-08-112023-08-11T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/157763eng2234-943XPURE: 71088310https://doi.org/10.3389/fonc.2023.1235237info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T18:14:21Zoai:run.unl.pt:10362/157763Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:44:58.552504Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
title The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
spellingShingle The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
Moreira Monteiro, António
hyperbaric oxygen
hyperbaric oxygen therapy
hyperbaric oxygenation
late radiation tissue injury
radiation injury
radiation proctitis
radiation-induced proctitis
radiotherapy
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
title_short The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
title_full The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
title_fullStr The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
title_full_unstemmed The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
title_sort The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study
author Moreira Monteiro, António
author_facet Moreira Monteiro, António
Alpuim Costa, Diogo
Mareco, Virgínia
Espiney Amaro, Carla
author_role author
author2 Alpuim Costa, Diogo
Mareco, Virgínia
Espiney Amaro, Carla
author2_role author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Moreira Monteiro, António
Alpuim Costa, Diogo
Mareco, Virgínia
Espiney Amaro, Carla
dc.subject.por.fl_str_mv hyperbaric oxygen
hyperbaric oxygen therapy
hyperbaric oxygenation
late radiation tissue injury
radiation injury
radiation proctitis
radiation-induced proctitis
radiotherapy
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
topic hyperbaric oxygen
hyperbaric oxygen therapy
hyperbaric oxygenation
late radiation tissue injury
radiation injury
radiation proctitis
radiation-induced proctitis
radiotherapy
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
description Funding Information: We thank Professor Elisabete Fernandes from the Faculdade de Medicina (Universidade de Lisboa) for collaborating on the statistical analysis. We also thank all the staff of the Centro de Medicina Subaquática e Hiperbárica (Armed Forces Hospital, Lisbon) for facilitating the consultation of the archived medical records. Publisher Copyright: Copyright © 2023 Moreira Monteiro, Alpuim Costa, Mareco and Espiney Amaro.
publishDate 2023
dc.date.none.fl_str_mv 2023-09-13T22:18:22Z
2023-08-11
2023-08-11T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/157763
url http://hdl.handle.net/10362/157763
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2234-943X
PURE: 71088310
https://doi.org/10.3389/fonc.2023.1235237
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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