The role of hyperbaric oxygen therapy in the treatment of radiation lesions

Introduction Cancer remains one of the leading causes of death worldwide, with 50–60% of patients requiring radiotherapy during the course of treatment. Patients’ survival rate has increased significantly, with an inevitable increase in the number of patients experiencing side effects from cancer therapy. One such effect is late radiation injuries in which hyperbaric oxygen therapy appears as complementary treatment. With this work we intend to divulge the results of applying hyperbaric oxygen therapy among patients presenting radiation lesions in our Hyperbaric Medicine Unit.Materials and methods Retrospective analysis of clinical records of patients with radiation lesions treated at the Hyperbaric Medicine Unit assessed by the scale Late Effects of Normal Tissues—Subjective, Objective, Management, Analytical (LENT-SOMA) before and after treatment, between October 2014 and September 2019 were included. Demographic characteristics, primary tumor site, subjective assessment of the LENT-SOMA scale before and after treatment were collected and a comparative analysis (Students t test) was done. Results 88 patients included: 33 with radiation cystitis, 20 with radiation proctitis, 13 with osteoradionecrosis of the mandible and 22 with radiation enteritis. In all groups, there was a significant decrease (p < 0.005) in the subjective parameter of the LENT-SOMA scale. Discussion Late radiation lesions have a major influence on patients’ quality of life. In our study hyperbaric oxygen therapy presents as an effective therapy after the failure of conventional treatments. Conclusion Hyperbaric oxygen therapy is an effective complementary therapy in the treatment of refractory radiation lesions. (AU)

The role of hyperbaric oxygen therapy in the treatment of radiation lesions.

INTRODUCTION: Cancer remains one of the leading causes of death worldwide, with 50-60% of patients requiring radiotherapy during the course of treatment. Patients' survival rate has increased significantly, with an inevitable increase in the number of patients experiencing side effects from cancer therapy. One such effect is late radiation injuries in which hyperbaric oxygen therapy appears as complementary treatment. With this work we intend to divulge the results of applying hyperbaric oxygen therapy among patients presenting radiation lesions in our Hyperbaric Medicine Unit. MATERIALS AND METHODS: Retrospective analysis of clinical records of patients with radiation lesions treated at the Hyperbaric Medicine Unit assessed by the scale Late Effects of Normal Tissues-Subjective, Objective, Management, Analytical (LENT-SOMA) before and after treatment, between October 2014 and September 2019 were included. Demographic characteristics, primary tumor site, subjective assessment of the LENT-SOMA scale before and after treatment were collected and a comparative analysis (Students t test) was done. RESULTS: 88 patients included: 33 with radiation cystitis, 20 with radiation proctitis, 13 with osteoradionecrosis of the mandible and 22 with radiation enteritis. In all groups, there was a significant decrease (p < 0.005) in the subjective parameter of the LENT-SOMA scale. DISCUSSION: Late radiation lesions have a major influence on patients' quality of life. In our study hyperbaric oxygen therapy presents as an effective therapy after the failure of conventional treatments. CONCLUSION: Hyperbaric oxygen therapy is an effective complementary therapy in the treatment of refractory radiation lesions.

Disfunção sexual nos doentes oncológicos: a importância de uma abordagem especializada / Sexual dysfunction among oncological patients: The importance of a specialized approach

OBJETIVOS: Determinação do impacto oncológico a nível afetivo/sexual assim como do grau de satisfação dos doentes quanto à informação recebida. Pretende‐se, adicionalmente, avaliar a importância da existência de uma abordagem especializada em sexologia durante o tratamento e seguimento oncológico. MÉTODOS: Estudo transversal que incluiu doentes oncológicos admitidos para consulta num serviço de radioterapia. Aplicação de um questionário e aferição de dados clínicos através do processo clínico. RESULTADOS: Amostra de 104 doentes, com uma média de 64,7 anos, em que a maioria (60,6%) refere ter disfunção sexual após o tratamento oncológico. Relativamente ao grau de informação, 62,5% encontram‐se satisfeitos quanto à informação fornecida pelos profissionais de saúde. Cerca de 2/3 dos doentes (66,4%) recorreriam a uma consulta de oncossexologia caso fossem referenciados pelo médico assistente. Não foram observadas diferenças estatisticamente significativas entre os subgrupos analisados relativamente ao impacto oncológico na sexualidade nem quanto à necessidade de uma abordagem especializada em sexologia. DISCUSSÃO: A abordagem da sexualidade nos doentes oncológicos engloba tanto o esclarecimento dos doentes como o tratamento das disfunções sexuais inerentes aos tratamentos. A existência de consultas de oncosexologia é uma forma de abordagem especializada, é do interesse da maioria dos nossos doentes. CONCLUSÕES: A sexualidade deve ser abordada com o doente oncológico desde o início da doença. Os cuidados especializados de oncossexologia são importantes ao constituírem uma via de redução do impacto oncológico na qualidade de vida

OBJECTIVES: Determination of the emotional and sexual impact after oncologic disease and patient's satisfaction regarding information provided by healthcare professionals. We also aim to evaluate the importance of sexology care during cancer treatment and follow‐up. METHODS: This is a cross‐sectional study including patients admitted for radiation therapy. A questionnaire and an assessment of clinical data were assessed. RESULTS: The study sample was composed by 104 patients. 60.6% had a negative impact on their sexual life after treatment and 62.5% were satisfied about the information given by healthcare professionals. About two thirds of the patients would accept sexology care during cancer treatment and/or follow‐up. After a sub‐group analysis, there were no statistically significant differences between groups regarding the prevalence of sexual dysfunction or needs for sexual care. DISCUSSION: There is a well‐known impact of cancer on sexuality since its diagnosis. Our patients feel themselves well informed about this by health professionals. Most of them would accept being referred to an oncosexology appointment. CONCLUSIONS: Sexuality must be discussed with cancer patients since their diagnosis. Oncosexuality care is necessary and desired by most patients as a mean for reduction of the cancer impact in their life quality

[Sexual dysfunction among oncological patients: The importance of a specialized approach]. / Disfunção sexual nos doentes oncológicos: a importância de uma abordagem especializada.

OBJECTIVES: Determination of the emotional and sexual impact after oncologic disease and patient's satisfaction regarding information provided by healthcare professionals. We also aim to evaluate the importance of sexology care during cancer treatment and follow-up. METHODS: This is a cross-sectional study including patients admitted for radiation therapy. A questionnaire and an assessment of clinical data were assessed. RESULTS: The study sample was composed by 104 patients. 60.6% had a negative impact on their sexual life after treatment and 62.5% were satisfied about the information given by healthcare professionals. About two thirds of the patients would accept sexology care during cancer treatment and/or follow-up. After a sub-group analysis, there were no statistically significant differences between groups regarding the prevalence of sexual dysfunction or needs for sexual care. DISCUSSION: There is a well-known impact of cancer on sexuality since its diagnosis. Our patients feel themselves well informed about this by health professionals. Most of them would accept being referred to an oncosexology appointment. CONCLUSIONS: Sexuality must be discussed with cancer patients since their diagnosis. Oncosexuality care is necessary and desired by most patients as a mean for reduction of the cancer impact in their life quality.

Neoadjuvant radiotherapy in the approach of locally advanced breast cancer.

BACKGROUND: Approximately 4% of European patients are diagnosed with locally advanced breast cancer (LABC), a clinical condition commonly associated with poorer prognosis. Systemic therapy is the recommended initial treatment and when inoperability criteria prevails, radiotherapy (RT) should be used for tumour downstaging. This study intends to evaluate the impact of neoadjuvant radiotherapy (NART) in the treatment of inoperable LABC. METHODS: A retrospective study of female patients, submitted to the NART between January 2014 and December 2018 at our institution. The evaluation of pathological response (pR) was made based on Pinder criteria. Primary endpoint: pR. Secondary endpoints: overall survival (OS) and progression-free survival (PFS). OS and PFS were calculated using the Kaplan-Meier method. Differences between groups were compared using Student's t-test, ANOVA (Analysis of variance) and χ2 test. The statistical analyses were performed using Stata (V.13). RESULTS: A total of 76 patients were included, 18% with breast complete response. The 5 years OS was 54% and PFS was 61%. Subgroup analysis showed that pR >90% is correlated with a better OS (p=0.004). Basal-like intrinsic subtype is correlated with worse OS and PFS (p<0.05). No relation was found between response and age, intrinsic subtype, treatment performed and clinical T stage. CONCLUSION: Our study confirms that NART is an effective downsizing treatment in inoperable LABC, allowing for a surgical resection regardless of the systemic treatment performed. Response to NART is independent of the intrinsic subtype and pR >90% is correlated with a better OS. Prospective studies to explore predictive response biomarkers are necessary in order to improve patient selection and optimisation of the treatment.