Managing Chronic Non-healing Ulcers After Definitive Radiation Therapy—Role of Hyperbaric Oxygen Therapy

One-half of the estimated 1.2 million new cases of invasive cancer will receive radiation therapy as a part of their cancer treatment and despite best efforts, 5% of patients will develop severe reactions to radiation therapy. These effects cause significant morbidity which may occur months or years after treatment. Management is often difficult and unsatisfactory. Hyperbaric oxygen is shown to have beneficial effects in all the three mechanisms known to cause the morbidity in irradiated tissues: HBO2 stimulates angiogenesis and secondarily improves tissue oxygenation; it reduces fibrosis; and it mobilizes and induces an increase of stem cells within irradiated tissues. Hyperbaric oxygen therapy is a treatment in which patients breathe 100% oxygen while inside a pressurized hyperbaric chamber. HBO treatment regimens consist of 1.5 to 2 hours per treatment for 20 to 40 treatments, and up to 60 treatments if needed. Evidence demonstrated that Hyperbaric Oxygen is safe and does not accelerate malignant growth or cause a dormant malignancy to be reactivated. Hyperbaric oxygen helps reduce morbidity, disfiguring sequelae and further need for corrective surgery. It is a cost-effective treatment for reducing mortality and morbidity in patients with radiation-induced wounds in any area or organ of the body and should be used as an adjunct to standard line of treatment with antibiotics and surgical debridement’s.