Published online Jul 21, 2021. doi: 10.3748/wjg.v27.i27.4413
Peer-review started: February 25, 2021
First decision: April 18, 2021
Revised: May 2, 2021
Accepted: June 22, 2021
Article in press: June 22, 2021
Published online: July 21, 2021
Radiotherapy (RT) is the backbone of multimodality treatment of more than half of cancer cases. Despite new modern RT techniques, late complications may occur such as radiation proctitis (RP). The natural history of RP is unpredictable. Minor symptoms may resolve spontaneously or require conservative treatment. On the other hand, for similar and uncomplicated clinical contexts, symptoms may persist and can even be refractory to the progressive increase in treatment measures. Over the last decades, an enormous therapeutic armamentarium has been considered in RP, including hyperbaric oxygen therapy (HBOT). Currently, the evidence regarding the impact of HBOT on RP and its benefits is conflicting. Additional prospective and randomised studies are necessary to validate HBOT’s effectiveness in the ‘real world’ clinical practice. This article reviewed the relevant literature on pathophysiology, clinical presentation, different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.
Core Tip: Over the last decades, an enormous therapeutic armamentarium has been considered in radiation proctitis (RP) management including hyperbaric oxygen therapy (HBOT). However, evidence regarding the impact of HBOT on RP and its benefits is conflicting. With the lack of consensus to guide the use of HBOT for the treatment of RP, the goal of this review was to synthesise the existing data, analyse results of previous studies, identify gaps in knowledge, and discuss RP’ management including a proposal of a therapeutic algorithm focusing on HBOT.