Treatment of radiation proctitis with hyperbaric oxygen
Treatment of radiation proctitis with hyperbaric oxygen
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DOI：
10.1016/j.radonc.2005.11.004
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发表时间：
2006-01-01
影响因子：
5.7
通讯作者：
Levin, W
中科院分区：
文献类型：
--
作者：
Jones, K;Evans, AW;Levin, W
背景与目的：放射性直肠炎是骨盆放射治疗后的潜在并发症。目前还没有标准的治疗方法，治疗结果也难以预测。我们报告了我们使用高压氧治疗（HBOT）治疗放射性直肠炎的经验，这些病例对标准药物治疗或激光治疗难以治愈。患者和方法：2000-2004年间，10例放射性直肠炎患者采用HBOT治疗（男3例，女7例，平均年龄65岁）。中位随访时间为25个月（范围6-43个月）。根据LENT-SOMA量表，在HBOT之前和之后对患者症状进行回顾性评分。结果：治疗前，3例患者为3级毒性（即需要输血），7例为2级毒性，主要症状为直肠疼痛和/或腹泻。HBOT耐受性良好，10名患者中有9名完成了完整的HBOT治疗计划。9名有症状的患者中有4名直肠出血完全停止，另外3名有所改善。5例有症状的患者中有3例直肠疼痛完全缓解。五名患者中有一名腹泻完全缓解，另外三名有所改善。在接受治疗的10名患者中，只有2名患者对HBOT没有反应。结论：HBOT可显著改善直肠出血、腹泻和直肠疼痛。对于放射性直肠炎常规治疗失败的患者，应给予HBOT治疗。2005爱思唯尔爱尔兰有限公司版权所有。
Background and purpose: Radiation proctitis is a potential complication following pelvic radiation therapy. There are no standard treatments and treatment outcomes are unpredictable. We report our experience with the use of hyperbaric oxygen treatment (HBOT) for radiation proctitis cases refractory to standard medical or laser therapy.Patients and methods: During the period 2000-2004, 10 patients with radiation proctitis were treated with HBOT (three males and seven females; mean age of 65). The median follow-up period was 25 months (range 6-43 months). Patient symptoms were retrospectively scored prior to, and following HBOT, based on the LENT-SOMA scale.Results: Prior to treatment, three patients had Grade 3 toxicity (i.e. requiring blood transfusions) and seven had Grade 2 toxicity with dominant symptoms of rectal pain and/or diarrhoea. HBOT was well tolerated and 9 of the 10 patients completed a full HBOT treatment program. Rectal bleeding completely stopped in four of nine symptomatic patients and improved in three others. Rectal pain completely remitted in three of five symptomatic patients. Diarrhea remitted completely in one of five patients and improved in three others. Of the 10 patients treated, only two did not respond to HBOT.Conclusions: Significant improvement of rectal bleeding, diarrhea and rectal pain is possible using HBOT. HBOT should be offered to patients who fail conventional treatments for radiation proctitis. (c) 2005 Elsevier Ireland Ltd. All rights reserved.