Hyperbaric Oxygen Therapy in Patients with Colon Cancer

Safety and Efficacy

The British Society of Gastroenterology recommends HBOT as a definitive treatment option for radiation-induced telangiectasia causing rectal bleeding in patients with a history of colorectal cancer 1, 2
HBOT induces neo-vascularization, tissue re-oxygenation, collagen neo-deposition, and fibroblast proliferation, eliciting responses in the majority of patients with chronic proctitis 3

HBOT is recognized as a treatment option for radiation-induced proctitis, which can occur after pelvic radiotherapy for various cancers including colorectal cancer 1, 2
For radiation-induced proctitis, patients typically require at least 30 sessions of HBOT to see significant benefit 1, 2
Lower-pressure HBO is probably ineffective for treating radiation-induced injury 2

The HOT2 study showed a trend toward benefit (p=0.09) of HBOT for radiation proctopathy, and the HORTIS IV study demonstrated greater healing in patients receiving HBO versus sham therapy 2
A review indicated that HBOT may improve outcomes for radiation proctitis, but further studies are necessary to establish correct patient selection criteria 3
The 2018 guidelines did not contraindicate the use of HBOT for symptom management in colorectal cancer patients, but identified a need for more research 4

The British Society of Gastroenterology suggests that patients should be assessed for valid indications for HBOT, such as radiation proctitis or wound healing complications 1, 2
Patients should be evaluated for cancer status, overall health status, and ability to tolerate multiple HBOT sessions before starting treatment 1, 2
Patients should be monitored for clinical response during the treatment course and understand that HBOT requires commitment to multiple sessions 1, 2