The effectiveness of hyperbaric oxygen therapy for managing radiation-induced proctitis – results of a 10-year retrospective cohort study

Introduction Despite modern radiotherapy (RT) techniques, radiation-induced proctitis (RIP) remains a significant complication of RT for pelvic organ malignancies. Over the last decades, an enormous therapeutic armamentarium has been considered in RIP, including hyperbaric oxygen therapy (HBOT). However, evidence regarding impact HBOT on RIP is conflicting. This study aims to evaluate effectiveness and safety treatment RIP. Methods Ten-year (2013-2023) retrospective analysis all consecutive patients with treated at Centro de Medicina Subaquática e Hiperbárica (CMSH) (Armed Forces Hospital – Lisbon, Portugal). Patients were exposed 100% 2.5 ATA, multiplace first-class chamber, 70-min periods, once daily, five times per week. Fisher’s exact test was performed using SPSS (version 23.0); p<0.05 accepted as statistically significant. Results Of total 151 88 included final analysis, whom 38.6% evidenced other concurrent soft tissue lesions. The most reported primary tumor prostate cancer (77.3%), followed by cervical (10.2%). Hematochezia observed clinical manifestation (86.4%). After median 60 sessions (interquartile range [IQR]: 40-87.5), 62.5% 31.8% achieved complete partial response, respectively, hematochezia resolution rate 93.7% (complete or partial). While responses require fewer than 70 terms overall symptoms (p=0.069), isolated tends least (p=0.075). Individuals two late radiation injuries associated response (p=0.029). Only about 5.7% did not respond treatment. Eighteen (20.5%) developed reversible ear barotrauma. number predictor side effects (odds ratio: 1.010; 95% confidence interval, 1.000-1.020; p=0.047). Conclusion proved be effective safe refractory medical and/or endoscopic treatments. real-world adds value published data management HBOT.