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Oncology/Post Radiation

Oncology/Post Radiation

Radiation Cystitis

Radiation cystitis is a complication that can occur after radiation therapy for cancer in the pelvic region, specifically the bladder, prostate, uterus, and rectum. Radiation therapy uses high-energy radiation to destroy cancer cells, but it can also damage healthy tissues in the pelvic area, including the bladder.

How Can HBOT Help?

  • Reduce inflammation in the bladder wall
  • Promote angiogenesis, the growth of new blood vessels which assists with wound healing
  • Help reduce risk of infection and improve bladder function

Osteoradionecrosis (ORN)

According to the Cleveland Clinic, Osteoradionecrosis (ORN) is a condition in which bone has died due to radiation exposure. It’s a side effect of radiation therapy for cancer in your head or neck. ORN can develop months or years after radiation treatment for cancer. Symptoms of osteoradionecrosis include pain, swelling and sores.

ORN most commonly affects your lower jaw (mandibular osteoradionecrosis), but it can also occur in your upper jaw (maxillary osteoradionecrosis), the front of your spine (vertebral osteoradionecrosis) or in any other bone exposed to significant radiation.

In rare cases, ORN can affect your skull. This is a potentially fatal condition.

Osteoradionecrosis is difficult to prevent and treat. Current prevention strategies are aimed at avoiding excess doses of radiation as well as maintaining excellent dental hygiene.[7] Treatments are variable depending on the provider and disease severity, and can range from medical treatment with antibiotics to hyperbaric oxygen therapy (HBO) to surgical debridement or reconstruction.[3]

How Can HBOT Help?

  • Stimulates angiogenesis and increases neovascularization
  • Increases cellular levels of oxygen
  • Increases fibroblast and osteoblast proliferation
  • Increases collagen formation in irradiated tissues

North Shore Health & Hyperbarics, in conjunction with an Oral surgeon, uses the Marx Protocol for the prevention and management of ORN. HBO prophylaxis before tooth extraction or dental implants in irradiated jaw is usually referred to as a “20/10 protocol” with 20 sessions of HBO at 2.5 ATA for 90 min on 100% oxygen prior to surgery, followed by 10 such sessions after surgery.ORN Treatment Protocol (Marx 30/10 Protocol) Marx established a protocol associating surgery and HBO; it consists of three stages. In stage I, after 30 sessions (100% oxygen, 2.4 ATA, 90 min/day, 5 day/week), wound is re-examined: in case of improvement, the patient completes a full course of 60 sessions. If there is no improvement, the patient is advanced to stage II: a sequestrectomy with primary closure is accomplished, with HBO if healing progresses without complication. If the wound dehisces, the patient is advanced to stage III: a resection is accomplished. In a patient whose initial presentation includes pathologic fracture, orocutaneous fistulae, or radiographic evidence of resorption to the inferior border, an initial course of 30 sessions is given and the patient directly enters in stage III. In stage III-R, 10 weeks after resection, the patient is given an additional 20 sessions in preparation for bone graft reconstruction.

(Pradeoth M. Korambayil) Role of Hyperbaric Medicine for Osteoradionecrosis and Post Irradiation Wounds: an Institutional Experience)

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