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Hyperbaric Oxygen Therapy for Delayed Radiation Injury

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Radiation Injury Website Photo1_edited.j

Hyperbaric Oxygen Therapy for Delayed Radiation Injury

Non-invasive cellular repair to stop chronic bleeding, relieve pain, and rebuild damaged tissue.

 

HBOT is approved for the treatment of delayed radiation injuries. 

  • FDA-Cleared for Soft Tissue & Bone Radiation Necrosis

  • Covered by Medicare & Major Private Insurances

  • Non-Invasive & Painless Outpatient Treatment​

Footnote: Radiation tissue damage can appear months or even years after cancer treatment. Insurance routinely covers HBOT for radiation-induced complications that fail to heal with standard care.

Radiation therapy is life-saving, but it can permanently damage the tiny blood vessels supplying healthy tissue near the treatment area. Over time, these blood vessels collapse, starving surrounding tissue of oxygen, causing chronic inflammation, scarring, bleeding, and non-healing wounds. Hyperbaric Oxygen Therapy (HBOT) forces 100% pure oxygen deep into starved, scarred tissue under high pressure—triggering angiogenesis (the creation of brand-new blood vessels) to permanently restore normal blood flow and heal damaged organs from the inside out.

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Covered Radiation Injury Conditions We Treat

  • Radiation Cystitis (Bladder): Chronic bladder pain, frequent urination, or persistent blood in urine caused by radiation to the pelvic region.

  • Radiation Proctitis (Bowel): Rectal bleeding, chronic pain, inflammation, or tissue scarring following pelvic radiation therapy.

  • Soft Tissue Radiation Necrosis: Non-healing skin breakdown, chest wall wounds, or breast tissue damage that fails to heal after cancer treatments.

  • Osteoradionecrosis (Bone Damage): Weakened, non-healing, or painful bone tissue—most commonly affecting the jaw, head, or neck.

  • Delayed Surgical & Reconstruction Wounds: Poor healing in skin or tissue that was previously exposed to radiation therapy.

How HBOT Repairs Radiation Damage 

  • Restores Lost Circulation: Floods tissues with 10–15 times normal oxygen levels to grow a new network of healthy blood capillaries.

  • Stops Chronic Bleeding & Pain: Rebuilds delicate tissue linings in the bladder, bowel, and skin to halt persistent internal bleeding.

  • Reverses Scarring & Tissue Tightness: Softens hard, fibrotic radiation scar tissue to restore natural flexibility and function.

Proven Long-Term Success:

  • Clinical studies show an 80%+ success rate in resolving bleeding and tissue pain for radiation cystitis and proctitis patients.

  • Durable Repair: Unlike medications that temporarily mask symptoms, HBOT rebuilds the underlying vascular structure for lasting, long-term healing.

  • Painless Treatment: Patients relax comfortably in a clear chamber, watching TV or resting while receiving treatment.

Studies on Delayed Radiation Injury and HBOT 

Outcomes of Radiation Injuries Using Hyperbaric Oxygen Therapy

An Observational Cohort Study

Niezgoda, Jeffrey A. MD, FACHM, MAPWCA, CHWS; Serena, Thomas E. MD, FACS, FACHM, MAPWCA; Carter, Marissa J. PhD, MAPWCA. Outcomes of Radiation Injuries Using Hyperbaric Oxygen Therapy: An Observational Cohort Study. Advances in Skin & Wound Care 29(1):p 12-19, January 2016. | DOI: 10.1097/01.ASW.0000473679.29537.c0 

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BACKGROUND

The late effects of radiation therapy following the treatment of cancer are a well-known consequence. Evidence increasingly supports the use of hyperbaric oxygen (HBO) as an adjunctive treatment in a variety of radiation injuries.

Results

A total of 2538 patient entries with 10 types of radiation injuries were analyzed. The 5 most common injuries were osteoradionecrosis (33.4%), dermal soft tissue radionecrosis (27.5%), radiation cystitis (18.6%), radiation proctitis (9.2%), and laryngeal radionecrosis (4.8%). Clinical outcomes following HBOT were positive with symptoms that improved or resolved varying from 76.7% to 92.6%, depending on injury type. Overall, although the mean symptom improvement score between some groups is statistically significant, the differences are probably not clinically meaningful. Patients with osteoradionecrosis had the highest mean symptom improvement score (3.24) compared with a mean of 3.04 for laryngeal radionecrosis.

Conclusions

Outcomes from a large patient registry of radiation-induced injuries support the continued therapeutic use of HBOT for radiation injuries.

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Role of Hyperbaric Medicine for Osteoradionecrosis and Post Irradiation Wounds: an Institutional Experience.

Korambayil PM, Ambookan PV, Pillai S, Karangath RR, George D. Indian J Surg Oncol. 2020 Sep;11(3):469-474. doi: 10.1007/s13193-020-01128-0. Epub 2020 Jun 15. PMID: 33013130; PMCID: PMC7501368.

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Abstract

To study the effectiveness of hyperbaric medicine in osteoradionecrosis and irradiation induced wounds. To evolve a protocol for management with combined surgical modality for irradiation induced injury. This study was carried out in the Plastic Surgery Department, from November 2011 to December 2018. A total of 30 patients with post irradiation patients subjected to hyperbaric oxygen therapy during the management were enrolled in the study. The results regarding the changes in wound and complications were noted. Out of 30 patients, 20 patients were with radiation injury involving the oral cavity, one patient with left lower limb, one with breast, 3 with radiation injury of cheek, 3 of mandible, one with radiation cystitis and one involving the tooth socket. One patient experienced reversible myopia as a complication of hyperbaric therapy. No other complications were noted. Hyperbaric therapy is a useful adjunct for surgery in management of osteoradionecrosis and post irradiation wound and proves therapeutic in some post irradiated wound where we cannot offer surgical correction.

 

Radiation-induced cystitis treated with hyperbaric oxygen
therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Nicklas Oscarsson, Bernd Müller, Anders Rosén, Pär Lodding, Johan Mölne, Daniel Giglio, Karin M Hjelle, Guro Vaagbø, Ole Hyldegaard, Michael Vangedal, Lisbeth Salling, Anders Kjellberg, Folke Lind, Otto Ettala, Olli Arola, Helén Seeman-Lodding

Lancet Oncol 2019; 20: 1602–14, Published Online
September 16, 2019

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Background

Late radiation cystitis is an adverse effect of cancer treatment with radiotherapy in the pelvic region. Symptoms of late radiation cystitis can be assessed with the Expanded Prostate Index Composite Score (EPIC). Previous reports indicate that hyperbaric oxygen therapy reduces symptoms from late radiation cystitis, but the evidence is predominantly based on non-randomised and retrospective studies. We aimed to assess whether hyperbaric oxygen therapy would mitigate symptoms of late radiation cystitis.

Interpretation

Our results suggest that hyperbaric oxygen therapy relieves symptoms of late radiation cystitis. We conclude that hyperbaric oxygen therapy is a safe and well-tolerated treatment.

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Patient Reported Outcome Measures following Hyperbaric Oxygen Therapy for Radiation Cystitis: A Multicenter Registry for Hyperbaric Oxygen Therapy Consortium

Rachel Moses, MD1, Eileen Brandes, MD1, Kevin Krughoff, MD1, Devin Cowan, BS2, Nicole Harlan, MD1, Judy Rees, PhD,MPH3, William Bihrle, III, MD1, Jay Buckey, Jr., MD3.
1Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA, 2Dartmouth College, Hanover, NH, USA, 3Dartmouth Geisel School of Medicine, Hanover, NH, USA.

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Background

Prior studies evaluating hyperbaric oxygen therapy (HBOT) have demonstrated reduced bladder bleeding interventions, however, few U.S. studies have evaluated HBOT’s association with patient-reported outcome measures (PROMs). The purpose of this study is to evaluate the feasibility of collecting PROMs of patient-reported hematuria events and bladder symptoms before and after HBOT through a multi-institutional registry.

Conclusions

In a novel, multi-institutional prospective data set, we demonstrate the feasibility of collecting PROMs in patients undergoing HBOT. HBOT reduced patient-reported hematuria events significantly but did not consistently reduce UDI scores in the small sample of patients with complete UDI data. Continued expansion of the registry may provide more generalizable results and allow for analysis of factors leading to improved or worsening UDI scores.

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Hyperbaric oxygen as an adjunctive therapy in treatment of malignancies, including brain tumours

Stępień K, Ostrowski RP, Matyja E. Hyperbaric oxygen as an adjunctive therapy in treatment of malignancies, including brain tumours. Med Oncol. 2016 Sep;33(9):101. doi: 10.1007/s12032-016-0814-0. Epub 2016 Aug 2. PMID: 27485098; PMCID: PMC4971045.

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Abstract

Hyperbaric oxygen (HBO) therapy is widely used as an adjunctive treatment for various pathological states, predominantly related to hypoxic and/or ischaemic conditions. It also holds promise as an approach to overcoming the problem of oxygen deficiency in the poorly oxygenated regions of the neoplastic tissue. Occurrence of local hypoxia within the central areas of solid tumours is one of the major issues contributing to ineffective medical treatment. However, in anti-cancer therapy, HBO alone gives a limited curative effect and is typically not applied by itself. More often, HBO is used as an adjuvant treatment along with other therapeutic modalities, such as radio- and chemotherapy. This review outlines the existing data regarding the medical use of HBO in cancer treatment, with a particular focus on the use of HBO in the treatment of brain tumours. We conclude that the administration of HBO can provide many clinical benefits in the treatment of tumours, including management of highly malignant gliomas. Applied immediately before irradiation, it is safe and well tolerated by patients, causing rare and limited side effects. The results obtained with a combination of HBO/radiotherapy protocol proved to be especially favourable compared to radiation treatment alone. HBO can also increase the cytostatic effect of certain drugs, which may render standard chemotherapy more effective. The currently available data support the legitimacy of conducting further research on the use of HBO in the treatment of malignancies.

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