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August 2004 Issue

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Hyperbaric Therapy Offers New Option For Brain Radiation Injuries

Published August 2004

Brain cancer patients from across the United States are coming to Cincinnati for a new, potentially life-saving hyperbaric treatment pioneered by Laurie Gesell, MD, in the Department of Emergency Medicine.

The patients suffer from brain-tissue damage called radionecrosis, a potential side effect of radiation therapy for brain tumors. Although most radionecrosis patients can be successfully treated with steroids, until recently those who are not helped by steroids had only one other option, surgery to remove the injured tissue.

Now Dr. Gesell, director of the Division of Hyperbaric Medicine, is treating the damaged tissue using hyperbaric oxygen therapy (HBOT), which involves placing patients in a sealed chamber and having them breathe pure oxygen at a pressure greater than one atmosphere. Although it's not yet certain how this treatment works on the damaged brain tissue, many patients have been healed completely.

Dr. Gesell and her team at University Hospital's new Brain Radionecrosis Center are working with a two-year, $450,000 grant from the National Cancer Institute and support from UH's Neuroscience Institute to determine the mechanism and efficacy of the treatment.

If HBOT proves as effective as early results indicate, the team plans to expand its study into a multi-center trial that could lead to the establishment of hyperbaric oxygen therapy as the first choice for brain radionecrosis patients.

"We've been treating patients with brain radionecrosis for over five years, and it appears to be working," says Dr. Gesell.

As for how it works: "We think the increased oxygen at pressure promotes the growth of new blood vessels into the injured tissue, helping the healing process. We've designed this study to compare how well hyperbaric oxygen therapy works compared with usual medications, and to find out whether the treatment really is making these new blood vessels grow.

"If we can show that hyperbaric oxygen therapy is better than medications, and understand how it works, we'll be able to help thousands of patients every year who get radiation therapy for brain tumors," she says.

Dr. Gesell, an emergency medicine physician, is working with Christopher Lindsell, PhD, of the Institute for Health Policy and Health Services Research, Ronald Warnick, MD, professor and neurosurgeon with the Mayfield Clinic and the Neuroscience Institute, and John Breneman, MD, professor of radiation oncology and neurosurgery and a neuroradiologist with the Neuroscience Institute

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