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Radiation Damage

Radiation Damage

Radiation injury is damage to soft tissue and bone following radiation therapy. 

There are early and late effects of radiation that are caused by ischemia, interruption of the blood supply and direct cell damage, which are sensitive to radiation.

Late effects of radiation that occur weeks and years later can be avoided with timely hyperbaric oxygen therapy.

Clinical applications of Hyperbaric Oxygen:

  • Helps in faster wound healing by formation of new microvasculature (angiogenesis)
  • Provides and prepares a better healthy tissue for skin grafts and dental implants if needed
  • Improves bone remodeling by stimulation new bone to growth (osteogenesis)
  • Prevents or arrests already existing infection
  • Prophylaxis – prevention of development delayed radiation injury

Results of Hyperbaric oxygen therapy in radiation injury:

  • Hyperbaric oxygen increases tissue radio-sensitivity (enhancing the effect of radiation/chemo therapy)
  • Hyperbaric oxygen prevents delayed radiation injury (swelling, pain and wounds due to radiation)
  • Hyperbaric oxygen enhances the immune system
  • Hyperbaric oxygen promotes new vascular growth preparing conditions for skin/bone grafts and implants
  • Hyperbaric oxygen improves bone remodeling by stimulation of new bone growth and removal of necrotic bone
  • Hyperbaric oxygen prevents or arrests already existing infection
  • Improves oxygenation of all body organs

Treatment protocol:
Hyperbaric oxygen sessions are 90 minutes long at 2.4 ATA of pressure of pure oxygen. Number of sessions needed depend on the seriousness of the condition and response to the therapy, which can be assessed with measurements of microcirculation. At BaroMedical, the screening of the clients and the progress of the therapy are monitored with most advanced equipment: Laser Doppler blood flow, tissue oxygen monitor and digital camera.

Soft tissue radiation injury:

  • Skin – skin damage (atrophy) and non-healing wounds
  • Genitourinary problems – radiation cystitis (inflammation of the bladder), proctitis (inflamma-tion of the rectum and anus) resulting in fistulas, abscesses, fibrosis and scar formation
  • Larynx – swelling, pain, difficulty swallowing and hoarseness

Bone radiation injury:

  • Bone cell destruction (osteoradionecrosis) – leading to spontaneous fractures, infections and delayed healing

Eye radiation injury:

  • Radiation-induced optic neuropathy – loss of vision

Further reading:
  1. Aanderud L, Thorsen E, Brattebo G, Forland M, Kristensen G: Hyperbaric oxygen treatment for radiation reactions. Tidsskr Nor Laegeforen; 30; 120(9):1020-2, Mar 2000
  2. Bem J, Bem S, Singh A: Use of hyperbaric oxygen chamber in the management of radiation-related complications of the anorectal region: report of two cases and review of the literature. Dis Colon Rectum; 43(10): 1435-8, Review, Oct 2000
  3. Bevers RFM, Bakker DJ, Kurth KH: Hyperbaric oxygen treatment for hemorrhagic radiation cystitis. The Lancet; 346:803-805, 1995
  4. Borruat FX, Schatz NJ, Glaser JS, Feun LG, Matos L: Visual recovery from radiation-induced optic neuropathy. The role of hyperbaric oxygen therapy.J Clin Neuroophthalmol;13 (2):98-101, Jun1993
  5. Cronje FJ: A review of the Marx protocols: Prevention and management of osteoradionecrosis by combining surgery and hyperbaric oxygen therapy. SADJ; 53(10): 469-71, Review, Oct 1998
  6. D'Souza, J; Goru, S; Goru, S; Brown, J; Vaughan, ED; Rogers, SN, The influence of hyperbaric oxygen on the outcome of patients treated for osteonecrosis: 8 year study; Int J Oral Maxillofac Surg; Epub  July 5,2007
  7. Davis JC, Dunn JM, Gates GA, Heimbach RD: Hyperbaric oxygen a new adjunct in the management of radiation necrosis. Arch Otolaryngol; 105 (2): 58-61, Feb 1979
  8. Del Pizzo JJ, Chew BH, Jacobs SC, Sklar GN; Treatment of radiation induced hemorrhagic cystitis with hyperbaric oxygen: long-term followup. J Urol; 160 (3 Pt 1): 731-3, Sep1998
  9. Feldmeier JJ, Heimbach RD, Davolt DA, Court WS, Stegmann BJ, Sheffield PJ: Hyperbaric oxygen as an adjunctive treatment for delayed radiation injury of the chest wall: a retrospective review of twenty-three cases. Undersea Hyperb Med; 22(4): 383-93, Dec1995
  10. Feldmeier JJ,Newman R, Davolt DA, Heimbach RD, et al: Prophylactic hyperbaric oxygen for patient undergoing salvage for recurrent head and neck cancers following full course irradiation. Undersea Hyper Med; 25(suppl): 101, 1998.
  11. Feldmeier JJ, Heimbach RD, Davolt DA, Stegmann BJ, Sheffield PJ: Hyperbaric oxygen as an adjunct of delayed radiation injuries of the extremities. Undersea Hyper Med; 25(suppl): 9, 2000
  12. Feldmeier JJ, Heimbach RD, Davolt DA, Court WS, et al: Hyperbaric oxygen as adjunctive for delayed injuries of the abdomen and pelvis. Undersea Hyper Med; 23(4): 205-213, 1996
  13. Filntisis GA, Moon RE, Kraft KL, Farmer JC, Scher RL, Piantadosi CA: Laryngeal radionecrosis and hyperbaric oxygen therapy: report of 18 cases and review of the literature. Ann Otol Rhinol Laryngol; 109 (6):554-62, Jun 2000
  14. Ganstrom G, Jaccobson M, Tjellstrom A: Titanium implants in irradiated tissue: benefits from Hyperbaric oxygen. The International Journal of Oral& Maxillofacial Implants; 7(1): 15-25, 1992
  15. Ganstrom G, Tjellstrom A, Branermark P, et al: Bone-anchored reconstruction of the irradiated head and neck cancer patient. Otolaryngology-Head and Neck Surgery; 108 (4):334-343, 1993
  16. Greenwood TW, Gilchrist AG: Hyperbaric oxygen and wound healing in post-irradiation head and neck surgery. Br J Surg; 50:394, 1973
  17. Hartmann KA, Almeling M, Carl UM, Schmitt G. Comment: Hyperbaric oxygenation (HBO) in the treatment of radiogenic side effects. Clinical experiences are decisive! Strahlenther Onkol; 174 (4): 221-2, Apr 1998
  18. Hart GB, Strauss MB: Hyperbaric oxygen in the management of radiation injury. In Schmutz J. (ed): Proceedings of the First Swiss Symposium on Hyperbaric Medicine. Basel, Switzerland: Foundation for Hyperbaric Medicine ; pp. 31-51, 1986
  19. Hart GB, Mainous EG: The treatment of radiation necrosis with hyperbaric oxygen Cancer; 37:2580-2585, 1976
  20. Jamil MU, Eckardt A, Franko W: Hyperbaric oxygen therapy. Clinical use in treatment of osteomyelitis, osteoradionecrosis and reconstructive surgery of the irradiated mandible. Mund Kiefer Gesichtschir; 4(5): 320-3, Sep 2000
  21. Kaufman T, Hirshowitz B, Monies-Chass I: Hyperbaric oxygen for postirradiation osteomyelitis of the chest wall. Harefuah 97:220-222, 271, 1979
  22. Kanatas, AN; Lowe, D; Harrison, J; Rogers, SN; Survey of the use of hyperbaric oxygen by maxillofacial oncologists in UK; British Journal of Oral Maxillofacial Surg; June 2005
  23. Kindwall E: Hyperbaric oxygen’s effect on radiation necrosis. Clinics in plastic surgery; 12 (3): 473-483, 1993
  24. London SD, Park SS, Gampper TJ, Hoard MA: Hyperbaric oxygen for the management of radionecrosis of bone and cartilage. Laryngoscope; 108(9): 1291-6, Sep 1998
  25. Maier A, Gaggl A, Klemen H, Santler G, Anegg U, Fell B, Karcher H, Smolle-Juttner FM, Friehs GB: Review of severe osteoradionecrosis treated by surgery alone or surgery with postoperative hyperbaric oxygenation. Br J Oral Maxillofac Surg; 38(3): 173-6, Jun 2000
  26. Marx RE, Johnson RP, Kline SN: Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin. J Am Dent Assn; 111:49-54, 1985
  27. Marx RE, Ehler WJ, Tayapongsak P, et al; Relationship of oxygen dose to angiogenesis induction in irradiation tissue. The American Jurnal of Surgery; 160:519-524, 1990
  28. Marx RE: A new concept in treatment of osteoradionecrosis. Journal of Oral Maxillofacial Surgery; 41:351-357, 1983
  29. Mathews R, Rajan N, Josefson L, Camporesi E, Makhuli Z: Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis. J Urol; 161:435-437, 1999
  30. Peusch-Dreyer D, Dreyer KH, Muller CD, Carl U. Management of postoperative radiation injury of the urinary bladder by hyperbaric oxygen (HBO). Strahlenther Onkol; 174 Suppl 3:99-100, Nov 1998
  31. Plafki C, Carl UM, Glag M, Hartmann KA: The treatment of late radiation effects with hyperbaric oxygenation (HBO). Strahlenther Onkol; 174 Suppl 3:66-8, Review, Nov 1998
  32. Pomeroy BD, Keim LW, Taylor RJ: Preoperative hyperbaric oxygen therapy for radiation induced injuries. J Urol; 159(5): 1630-2, May 1998
  33. Rijkmans BG, et al: Succesful treatment of radiation cystitis with hyperbaric oxygen Eur Urol; 16:354-356, 1989
  34. Roden D, Bosley TM, Fowble B, Clark J, Savino PJ, Sergott RC, Schatz NJ: Delayed radiation injury to the retrobulbar optic nerves and chiasm. Clinical syndrome and treatment with hyperbaric oxygen and corticosteroids. Ophthalmology; 97(3): 346-51, Mar 1990
  35. Vudiniabola S, Pirone C, Williamson J, Goss AN: Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones. Int J Oral Maxillofac Surg; 29(6): 435-8, Dec 2000
  36. Vudiniabola S, Pirone C, Williamson J, Goss AN: Hyperbaric oxygen in the prevention of osteoradionecrosis of the jaws. Aust Dent J; 44(4): 243-7, Dec 1999
  37. Williams J, Clarke D, Dennis WA, et al: The treatment of pelvic soft tissue radiation necrosis with hyperbaric oxygen. Am J Obstet Gynecol; 167(2):412-416, 1992
  38. Weiss JP, Mattei DM, Neville EC, Hanno PM. Hyperbaric oxygen: Primary treatment of radiation-induced cystitis with hyperbaric oxygen: 10-year experience. J Urol; 151 (6): 1514-1517, 1994

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A guided tour of hyperbaric oxygen therapy for Post Radiation Recovery

Cancer Recovery

A M., North Vancouver, BC

"...I found the sessions to be very friendly and efficient. I would highly recommend this treatment."

Radiation necrosis

G H,  Langley, BC

"I felt strongly that through my treatments, the staff and practitioners at Baromedical made my best outcomes their top priority.

The team responsible for my treatment was professional and very helpful and had a direct impact on my positive results.

Thank you Baromedical. You have made me feel like my old self again, confident and strong enough to face the next leg of my treatment journey. "

Proudly serving Metro Vancouver and British Columbians with hyperbaric oxygen services and wound care since 1999

© 1999- BaroMedical Research Centre, Inc. All Rights Reserved

7850 Sixth Street - Burnaby V3N 3N3 - British Columbia - Vancouver - CANADA - Ph: 604-777-7055

 Information contained on this site is intended for general consumer understanding and education. It should not be used as a substitute for any medical professional opinion, advice or prescribed medication nor should it serve as diagnosis or treatment of health problems.