Hyperbaric Oxygen Treatment, Alpha-Tocopherol, and Ascorbic Acid are Effective for Reducing Late Radiation-induced Side Effects of Pelvic Radiation Therapy

Abstract

Pelvic radiotherapy (RT) is a key aspect in the management of genitourinary (GU) and gynecologic (GYN) malignancies. Pelvic irradiation may result in urinary and intestinal toxicities. Late radiation-induced normal tissue toxicity can be difficult to manage and significantly impact quality of life. To better appreciate radiation-induced late effects and their potential management, we undertook an analysis of a prospective treatment protocol designed to investigate the efficacy of hyperbaric oxygen therapy (HBOT), oral alphatocopherol (AT) and ascorbic acid (AA) in patients with pelvic radiation disease. An REB approved retrospective review of a prospective adult radiation late effects (LE) treatment protocol was conducted. Twenty patients referred to a multidisciplinary late effects clinic at a tertiary care cancer center were screened to identify those with GU and GYN malignancies who had received pelvic RT. Patient, tumor and treatment factors were abstracted and analyzed. The median time to LE onset, LE symptoms, maximal initial Common Terminology Criteria for Adverse Events Version 4.0 (CTCAE) grade, LE treatment and duration and maximal post CTCAE grade were analyzed.