Hyperbaric oxygen therapy for radiation-induced brain injury in children

Paul J. Chuba, Patricia Aronin, Kanta Bhambhani, Michael Eichenhorn, Lucia Zamarano, Paul Cianci, Michael Muhlbauer, Arthur T. Porter, James Fontanesi

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

BACKGROUND. Radiation-induced necrosis (RIN) of the brain is a complication associated with the use of aggressive focal treatments such as radioactive implants and stereotactic radiosurgery. In an attempt to treat patients with central nervous system (CNS) RIN, ten patients received hyperbaric oxygen treatment (HBOT). METHODS. Patients presented with new or increasing neurologic deficits associated with imaging changes after radiotherapy. Necrosis was proven by biopsy in eight cases. HBOT was comprised of 20-30 sessions at 2.0 to 2.4 atmospheres, for 90 minutes-2 hours. Sites of RIN included the brain stem (n = 2), posterior fossa (n = 1), and supratentorial fossa (n = 7). Histologic types included brain stem glioma (n = 2), ependymoma (n = 2), germinoma (n = 2), low grade astrocytoma (n = 1), oligodendroglioma (n = 1), glioblastoma multiforme (n = 1), and arteriovenous malformation (n = 1). RESULTS. Initial improvement or stabilization of symptoms and/or imaging findings were documented in all ten patients studied and no severe HBOT toxicity was observed. Four patients died, with the cause of death attributed to tumor progression. Five of six surviving patients were improved by clinical and imaging criteria; one patient was alive with tumor present at last follow-up. CONCLUSIONS. HBOT may prove to be an important adjunct to surgery and steroid therapy for CNS RIN.

Original languageEnglish (US)
Pages (from-to)2005-2012
Number of pages8
JournalCancer
Volume80
Issue number10
DOIs
StatePublished - Nov 15 1997

Fingerprint

Hyperbaric Oxygenation
Brain Injuries
Radiation
Necrosis
Oxygen
Brain Stem
Therapeutics
Central Nervous System
Germinoma
Oligodendroglioma
Ependymoma
Radiosurgery
Arteriovenous Malformations
Astrocytoma
Glioblastoma
Neurologic Manifestations
Atmosphere
Glioma
Cause of Death
Neoplasms

Keywords

  • Central nervous system
  • Children
  • Hyperbaric oxygen therapy
  • Radiation-induced necrosis
  • Stereotactic radiosurgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Chuba, P. J., Aronin, P., Bhambhani, K., Eichenhorn, M., Zamarano, L., Cianci, P., ... Fontanesi, J. (1997). Hyperbaric oxygen therapy for radiation-induced brain injury in children. Cancer, 80(10), 2005-2012. https://doi.org/10.1002/(SICI)1097-0142(19971115)80:10<2005::AID-CNCR19>3.0.CO;2-0

Hyperbaric oxygen therapy for radiation-induced brain injury in children. / Chuba, Paul J.; Aronin, Patricia; Bhambhani, Kanta; Eichenhorn, Michael; Zamarano, Lucia; Cianci, Paul; Muhlbauer, Michael; Porter, Arthur T.; Fontanesi, James.

In: Cancer, Vol. 80, No. 10, 15.11.1997, p. 2005-2012.

Research output: Contribution to journalArticle

Chuba, PJ, Aronin, P, Bhambhani, K, Eichenhorn, M, Zamarano, L, Cianci, P, Muhlbauer, M, Porter, AT & Fontanesi, J 1997, 'Hyperbaric oxygen therapy for radiation-induced brain injury in children', Cancer, vol. 80, no. 10, pp. 2005-2012. https://doi.org/10.1002/(SICI)1097-0142(19971115)80:10<2005::AID-CNCR19>3.0.CO;2-0
Chuba, Paul J. ; Aronin, Patricia ; Bhambhani, Kanta ; Eichenhorn, Michael ; Zamarano, Lucia ; Cianci, Paul ; Muhlbauer, Michael ; Porter, Arthur T. ; Fontanesi, James. / Hyperbaric oxygen therapy for radiation-induced brain injury in children. In: Cancer. 1997 ; Vol. 80, No. 10. pp. 2005-2012.
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AB - BACKGROUND. Radiation-induced necrosis (RIN) of the brain is a complication associated with the use of aggressive focal treatments such as radioactive implants and stereotactic radiosurgery. In an attempt to treat patients with central nervous system (CNS) RIN, ten patients received hyperbaric oxygen treatment (HBOT). METHODS. Patients presented with new or increasing neurologic deficits associated with imaging changes after radiotherapy. Necrosis was proven by biopsy in eight cases. HBOT was comprised of 20-30 sessions at 2.0 to 2.4 atmospheres, for 90 minutes-2 hours. Sites of RIN included the brain stem (n = 2), posterior fossa (n = 1), and supratentorial fossa (n = 7). Histologic types included brain stem glioma (n = 2), ependymoma (n = 2), germinoma (n = 2), low grade astrocytoma (n = 1), oligodendroglioma (n = 1), glioblastoma multiforme (n = 1), and arteriovenous malformation (n = 1). RESULTS. Initial improvement or stabilization of symptoms and/or imaging findings were documented in all ten patients studied and no severe HBOT toxicity was observed. Four patients died, with the cause of death attributed to tumor progression. Five of six surviving patients were improved by clinical and imaging criteria; one patient was alive with tumor present at last follow-up. CONCLUSIONS. HBOT may prove to be an important adjunct to surgery and steroid therapy for CNS RIN.

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