The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.
Support Care Cancer. 2013 Jul;21(7):1797-800. doi: 10.1007/s00520-013-1811-x. Epub 2013 Apr 27.
Repeated episodes of acute bowel obstruction is a potential complication following pelvic radiation therapy. It has been previously thought that hyperbaric oxygen therapy (HBOT) may not be useful for treatment of such obstructive episodes. We report our experience with the use of HBOT for recurrent radiation-induced acute bowel obstruction.
This is a retrospective case series. Radiological imaging had excluded the presence of recurrent or new cancer. Possible predisposing causes for acute obstruction had been treated and had not led to resolution of symptoms or had been excluded.
During 2007-2010, five patients with recurrent episodes of acute obstructive bowel symptoms following previous therapeutic pelvic irradiation were referred for HBOT (four females and one male; median age 56; range 48-72). The primary tumours sites were the endometrium (n = 2), ovary, cervix and prostate (n = 1 each), and patients were treated 2-17 (median 9) years previously with radiotherapy. Before HBOT, patients were experiencing acute obstructive bowel symptoms at 1-6 weekly intervals. Four patients had progressive weight loss. Patients received 100 % oxygen in a multiplace hyperbaric chamber at a pressure of 2.4 atm absolute for up to 90 min once a day, 5 to 7 days weekly. All patients were initially referred for 40 sessions of HBOT. Three patients required a further extra 20 sessions for complete resolution of bowel symptoms. HBOT was well tolerated with no side effects. Patients have remained well after 6-24 months of follow-up.
HBOT may be an effective treatment of radiation-induced bowel obstruction and deserves prospective evaluation.
盆腔放疗后，反复发生急性肠梗阻是一种潜在的并发症。此前人们认为高压氧治疗（HBOT）可能对治疗这种梗阻性发作无效。我们报告了使用 HBOT 治疗复发性放射性急性肠阻塞的经验。
这是一个回顾性病例系列。放射影像学排除了复发性或新发癌症的存在。对可能导致急性梗阻的潜在原因进行了治疗，但没有导致症状缓解，或者已排除这些原因。
2007 年至 2010 年间，5 例先前接受过盆腔放疗的患者因复发性急性肠梗阻症状而接受 HBOT（4 名女性和 1 名男性；中位年龄 56 岁；范围 48-72 岁）。原发肿瘤部位为子宫内膜（n = 2）、卵巢、宫颈和前列腺（n = 1 例），患者分别于 2-17 年前（中位 9 年）接受放疗。在 HBOT 之前，患者每 1-6 周经历一次急性肠梗阻症状。4 例患者体重持续下降。患者在 2.4 绝对大气压的多体位高压舱中每天接受 100%的氧气治疗，每次 90 分钟，每周 5-7 次。所有患者最初都接受了 40 次 HBOT 治疗。3 名患者还需要额外的 20 次治疗，以完全缓解肠道症状。HBOT 耐受性良好，无副作用。在 6-24 个月的随访后，患者状况良好。
HBOT 可能是治疗放射性肠阻塞的有效方法，值得进一步前瞻性评估。
