[abstract] EFFECTIVENESS OF HYPERBARIC OXYGEN THERAPY FOR THE TREATMENT OF SOFT TISSUE RADIONECROSIS OF THE BRAIN

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[abstract] EFFECTIVENESS OF HYPERBARIC OXYGEN THERAPY FOR THE TREATMENT OF SOFT TISSUE RADIONECROSIS OF THE BRAIN

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Title: [abstract] EFFECTIVENESS OF HYPERBARIC OXYGEN THERAPY FOR THE TREATMENT OF SOFT TISSUE RADIONECROSIS OF THE BRAIN
Author: Gesell, LB; Warnick, RE; Breneman, JC; Albright, R; Racadio, JM; Mink, S
Abstract: INTRODUCTION: Hyperbaric oxygen therapy (HBOT) is an emerging treatment for brain radiation injury. We report our results of the effect that HBOT had on progressive radiation induced brain necrosis. METHODS: Patients who developed clinical and radiographic evidence of necrosis after radiation therapy for tumor or vascular malformation were evaluated for HBOT. Radionecrosis was diagnosed by PET/SPECT imaging or biopsy in tumor patients. Individuals received 20-60 HBOT at 2.5 ATA for 90 min and were followed prospectively utilizing subjective assessments, neurological examinations and MRI's. RESULTS: Twenty-nine patients were referred over four years for clinical and radiographic evidence of necrosis after radiation treatment for tumor (16-gliomas, 8-metastases, 3-meningioma, 1-neuroblastoma) or vascular malformation (1-AVM). The mean age of the patients was 50 years (27-74). There were 14 males and 15 females. Radiation therapy received by patients: 17 stereotactic radiosurgery, 21-whole brain irradiation, 11-seed implantation. Eighteen patients received two or more types of radiation therapy. Prior to HBOT, patients had progressive neurological deficits, increasing steroid requirements (mean dexamethasone 18mg/day prior to HBOT), and MRI's demonstrating an expanding ring-enhancing mass with extensive surrounding edema. Neurologic examination during HBOT: 17-improved, 10-stabilized, 2-worsened. Subjective assessment during HBOT: 19-improved, 10-stabilized, 0-worsened. Steroid requirement during HBOT: 20-decreased, 7-stabilized, 2-increased. MRI during HBOT: 11-improved, 15-stabilized, 3-worsened. The three patients who worsened on MRI developed progression of tumor. During post-HBOT follow-up, 15 patients developed recurrence of malignancy and expired. The benefit of HBOT was most obvious in four patients with benign pathologies (meningioma, AVM) who are alive and well at four years after HBOT. CONCLUSIONS: Our experience supports that HBOT is an effective treatment for patients who develop brain radiation necrosis. hyperbaric oxygen, brain radiation necrosis
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1146
Date: 2002

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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