Niezgoda JA, Serena TE, Carter MJ, et al.
Advances in skin & wound care. Date of publication 2016 Jan 1;volume 29(1):12-19.
1. Adv Skin Wound Care. 2016 Jan;29(1):12-19.
Outcomes of Radiation Injuries Using Hyperbaric Oxygen Therapy: An Observational
Cohort Study.
Niezgoda JA(1), Serena TE, Carter MJ.
Author information:
(1)Jeffrey A. Niezgoda, MD, FACHM, MAPWCA, CHWS, is President, American College
of Hyperbaric Medicine; President/Chief Medical Officer, WebCME; President/Chief
Medical Officer, AZH; and Industry Consultant for Hyperbaric and Wound Care,
Milwaukee, Wisconsin. Thomas E. Serena, MD, FACS, FACHM, MAPWCA, is Founder/Chief
Executive Officer/Medical Director, SerenaGroup, Cambridge, Massachusetts;
President, American Professional Wound Care Association; and Vice President,
American College of Hyperbaric Medicine. Marissa J. Carter, PhD, MAPWCA, is
President, Strategic Solutions, Inc, Cody, Wyoming. Drs Niezgoda and Serena have
disclosed that the American College of Hyperbaric Medicine has received funding
from the Eric P. Kindwall, MD, Foundation. Dr Carter has disclosed that her
company is remunerated for participation in review activities such as data
monitoring boards, statistical analysis, and end point committees, and received
payment for writing or reviewing the manuscript; and she is a consultant to the
SerenaGroup.
BACKGROUND: The late effects of radiation therapy following the treatment of
cancer are a well-known consequence. Evidence increasingly supports the use of
hyperbaric oxygen (HBO) as an adjunctive treatment in a variety of radiation
injuries.
OBJECTIVE: To present the findings of a new registry of radiation injuries that
was developed to evaluate the outcomes and treatment parameters of HBO treatment
(HBOT) when applied to patients experiencing the late effects of radiation
therapy.
DESIGN: Observational cohort.
SETTING: Hyperbaric oxygen clinical treatment facilities in the United States.
PATIENTS: A total of 2538 patients with radiation-induced injuries.
MEASUREMENTS: Injury type, patient age, gender, diabetes, end-stage renal
disease, collagen vascular disease, coronary artery disease/peripheral vascular
disease, on anticoagulant medication, on systemic steroid medication, patient is
current smoker, patient abuses alcohol, symptoms reported, duration of symptoms,
symptom progression prior to HBOT, transfusion units, HBOT time, HBOT count, HBO
chamber pressure, HBO time in chamber, and patient outcomes.
RESULTS: A total of 2538 patient entries with 10 types of radiation injuries were
analyzed. The 5 most common injuries were osteoradionecrosis (33.4%), dermal soft
tissue radionecrosis (27.5%), radiation cystitis (18.6%), radiation proctitis
(9.2%), and laryngeal radionecrosis (4.8%). Clinical outcomes following HBOT were
positive with symptoms that improved or resolved varying from 76.7% to 92.6%,
depending on injury type. Overall, although the mean symptom improvement score
between some groups is statistically significant, the differences are probably
not clinically meaningful. Patients with osteoradionecrosis had the highest mean
symptom improvement score (3.24) compared with a mean of 3.04 for laryngeal
radionecrosis.
LIMITATIONS: Limited data were available on patient comorbidities and symptom
severity.
CONCLUSIONS: Outcomes from a large patient registry of radiation-induced injuries
support the continued therapeutic use of HBOT for radiation injuries.
DOI: 10.1097/01.ASW.0000473679.29537.c0
PMID: 26650092
