Chronic radiation proctitis treated with hyperbaric oxygen.

Chronic proctitis is a well-known complication of therapeutic irradiation. The results of hyperbaric oxygen therapy (HBO2) used in the treatment of chronic radiation proctitis are reported. From 1992 to 1995, 14 patients with chronic radiation-induced proctitis were treated with HBO2. Nine patients were treated in a monoplace chamber at 2.0 atm abs (203 kPa O2), and five patients were treated at 2.36 atm abs (239 kPa O2). Eight patients experienced complete resolution of symptoms and one patient had substantial improvement for a total response rate of 64%. Follow-up ranged from 5 to 35 mo. (mean 17 mo.). Five patients (36%) were classified as non-responders. Three experienced significant improvement during treatment but relapsed soon after therapy was discontinued, whereas two had no symptomatic improvement. Responders who had sigmoidoscopy after therapy showed documented improvement whereas no non-responders showed improvement. The authors conclude that HBO2 therapy should be considered in patients with chronic radiation proctitis.