Late radiation sequelae in women after breast-conserving cancer therapy: effects of hyperbaric oxygen therapy

Background

Persisting symptomatology after breast-conserving surgery and radiation is frequently reported. In most cases symptoms in the breast resolve without further treatment. In some instances, however, pain, erythema and edema can persist for years and can impact on the patient's quality of life. Hyperbaric oxygen therapy was shown to be effective as treatment for late radiation sequelae. The objective of this study was to assess the efficacy of hyperbaric oxygen therapy in symptomatic patients after breast cancer treatment.

Patients and method

Forty-four patients with persisting symptomatology after breast-conservation therapy were prospectively observed. Thirty-two women received hyperbaric oxygen therapy in a multiplace chamber for a median of 25 sessions (7-60). One hundred per cent oxygen was delivered at 240 kPa for 90-min sessions, five times per week. Twelve control patients received no further treatment. Changes throughout the irradiated breast tissue were scored before and after hyperbaric oxygen therapy, using modified LENT-SOMA criteria.

Results

Hyperbaric oxygen therapy patients showed a significant reduction in pain, edema and erythema scores as compared with untreated controls (P < 0.001). Fibrosis and teleangiectasia, however, were not significantly affected by hyperbaric oxygen therapy. Seven out of 32 women were free of symptoms after hyperbaric oxygen therapy, whereas all 12 patients in the control group had persisting complaints.

Conclusion

Hyperbaric oxygen therapy should be considered as a treatment option for patients with persisting symptomatology following breast-conserving therapy.