Hyperbaric oxygen therapy for late rectal and bladder toxicity after radiation in prostate cancer patients. a symptom control and quality-of-life study

LetterHyperbaric Oxygen Therapy for Late Rectal and Bladder Toxicity after Radiation inProstate Cancer Patients. A Symptom Control and Quality-of-life Study Sir d Radiation therapy achieves a high level of disease of them: physical functioning, role physical, social func- control and cure rates for organ-confined prostate cancer tioning, role emotional and mental health.
but a 5e20% incidence of late rectal/bladder toxicity can The use of HBOT was a very effective treatment for be expected . The aim of our study was to investigate the ameliorating symptoms, particularly bleeding, and quality effects of hyperbaric oxygen therapy (HBOT) on symptom of life in patients suffering from late rectal and bladder control and quality of life for late radiation proctitis and/or toxicity. As far as we know, only the study published by Clark et al. has presented data for SOMA-LENT measures Between June 2006 and June 2008, 257 consecutive patients were studied who had been treated with radiationtherapy for prostate cancer. Clinical, pharmacological and R. Fuentes-Raspall, J.M. Inorizaz, M.J. Martí-Utzetz, dosimetric parameters were collected for all patients in on-Sanzy, P. Garcia-Martinz, G. Oliu-Isernz order to study prognostic factors. Patients with grade *Catalan Institute of Oncology, Hospital Universitari “Josep Trueta” 2 toxicity were entered onto an HBOT treatment pro- yInstitut de Recerca Biomedica de Girona, IDIBGi, Spain gramme, which includes clinical measures of toxicity (by zUnit of Hyperbaric Medicine, Hospital de Palamos, Girona, Spain means of the CTCv3 and SOMA-LENT grading systems) andquality of life (using the SF36 tests before and after HBOT and every 6 months thereafter). Late grade 2 rectal and/orbladder toxicity were diagnosed in 24 (9.3%) patients.
[1] Dearnaley DP, Sydes MR, Graham JD, et al. Escalated-dose In total, 14 patients were treated with HBOT; 10 versus standard-dose conformal radiotherapy in prostate non-bleeders were not considered for HBOT. Toxicity values cancer: first results from the MRC RT01 randomised measured by SOMA-LENT before HBOT, immediately after- controlled trial. Lancet Oncol 2007;8:475e487.
wards and 6 months later showed a statistically significant [2] Zelefsky MJ, Levin EJ, Hunt M, et al. Incidence of late rectal and improvement after HBOT. Rectal: 6.54 Æ 1.66, 1.54 Æ 1.33 urinary toxicities after three-dimensional conformal radio-therapy and intensity-modulated radiotherapy for localized and 0.54 Æ 1.13 (P ¼ 0.000). Bladder: 8.25 Æ 4.58, 1.75 Æ 1.71 prostate cancer. Int J Radiat Oncol Biol Phys 2008;70(4): (P ¼ 0.037) and 0.75 Æ 0.96 (P ¼ 0.018); SF36 at the same intervals comparing the eight original components (phys- [3] Clarke RE, Tenorio LMC, Hussey JR, et al. Hyperbaric oxygen ical functioning, role physical, bodily pain, general health, treatment of chronic refractory radiation proctitis: a random- vitality, social functioning, role emotional and mental ized and controlled double-blind crossover trial with long- health) showed statistically significant improvement in five term follow up. Int J Radiat Oncol Biol Phys 2008;72:134e143.
0936-6555/$36.00 Ó 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Fuentes-Raspall R, et al., Hyperbaric Oxygen Therapy for Late Rectal and Bladder Toxicity after Radiation inProstate Cancer Patients. A Symptom Control and Quality-of-life Study, Clinical Oncology (2012), doi:10.1016/j.clon.2012.03.014

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