Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues: a literature review

AbstractLate complications are one of the major factors limiting radiotherapy treatment, and their treatment is not codified. Hyperbaric oxygen(HBO) has been used in combination with radiotherapy for over half a century, either to maximise its effectiveness or in an attempt to treatlate complications. In this latter case, retrospective trials and case reports are prevailing in literature. This prompted European Society forTherapeutic Radiotherapy and Oncology and European Committee for Hyperbaric Medicine to organise a consensus conference in October2001, dealing with the HBO indications on radiotherapy for the treatment and prevention of late complications. This updated literaturereview is part of the documents the jury based its opinion on. A systematic search was done on literature from 1960 to 2004, by only takinginto account the articles that appeared in peer review journals. Hyperbaric oxygen treatment involving complications to the head and neck,pelvis and nervous system, and the prevention of complications after surgery in irradiated tissues have been studied. Despite the smallnumber of controlled trials, it may be indicated for the treatment of mandibular osteoradionecrosis in combination with surgery,haemorrhagic cystitis resistant to conventional treatments and the prevention of osteoradionecrosis after dental extraction, whose level ofevidence seems to be the most significant though randomised trials are still necessary. The other treatment methods are also outlined for eachlocation.