# Hyperbaric oxygen for late radiation injury

Source: https://onco.cc/technologies/hyperbaric-oxygen-radiation-injury/  
OnCo record `hyperbaric-oxygen-radiation-injury` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Breathing pure oxygen in a pressurised chamber, over 30 to 40 sessions, helps heal radiation damage to the jaw, bladder and bowel that appears years after treatment. A Cochrane review found moderate-quality evidence of benefit for these sites, and little for others.

## Summary

Late radiation tissue injury results from progressive small-vessel damage and fibrosis, leaving hypoxic tissue that will not heal. Hyperbaric oxygen (100 percent oxygen at 2 to 2.5 atmospheres for 90 minutes, typically 30 to 40 sessions) raises tissue oxygen tension, stimulating angiogenesis and fibroblast function. A 2016 Cochrane review of 14 randomised trials found moderate-quality evidence that hyperbaric oxygen improves outcomes in radiation proctitis, osteoradionecrosis of the jaw (including healing after dental extraction) and haemorrhagic cystitis, with insufficient evidence for radiation neuropathy, brain necrosis and soft-tissue injury of other sites. Adverse effects are middle-ear barotrauma, transient myopia and, rarely, oxygen seizures. Access is limited to specialised chambers and the course is time-consuming.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-10
- Tags: complementary; supportive-care; evidence:moderate
- Principle: Supraphysiological oxygen gradients drive neovascularisation and collagen synthesis in chronically hypoxic irradiated tissue, allowing healing to restart.
- Strengths: Cochrane moderate-quality evidence for proctitis, cystitis and jaw necrosis; Well-defined protocol; Few serious adverse effects
- Limitations: 30 to 40 sessions at a specialised centre; Little evidence for other sites; Barotrauma and rare seizures

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Hyperbaric_medicine
- Cochrane: hyperbaric oxygen therapy for late radiation tissue injury (2016): https://doi.org/10.1002/14651858.CD005005.pub4

## Connected records

- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- fronts: [Radiation Therapy](https://onco.cc/fronts/radiation/), [Recovery & Rejuvenation](https://onco.cc/fronts/rejuvenation/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Bowel function after pelvic radiotherapy](https://onco.cc/technologies/bowel-after-pelvic-radiotherapy/), [Dry mouth, teeth and taste after head and neck radiotherapy](https://onco.cc/technologies/dry-mouth-teeth-after-head-neck-radiotherapy/), [Evidence-based integrative oncology](https://onco.cc/technologies/integrative-oncology/), [Hyperbaric oxygen sold as rejuvenation](https://onco.cc/technologies/rejuv-frontier-hyperbaric-oxygen-claims/), [Palliative radiotherapy](https://onco.cc/technologies/palliative-radiotherapy/), [Scars, stiffness and contracture: shoulders, necks and jaws](https://onco.cc/technologies/rejuv-rehab-scar-contracture/), [Skin during and after radiotherapy: dressings, steroids and what lasts](https://onco.cc/technologies/radiation-skin-recovery/), [Teeth, jaws and facial growth after treatment in childhood](https://onco.cc/technologies/rejuv-paed-teeth-and-face/)
- terms: [Late effects and survivorship toxicity](https://onco.cc/terms/late-effects/)
- bottlenecks: [Survivorship and late effects are neglected](https://onco.cc/bottlenecks/b-survivorship/)
- key papers: [Hyperbaric oxygen therapy for late radiation tissue injury](https://onco.cc/key-papers/paper-bennett-cochrane-database-syst-rev/)
- roadmaps: [Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH](https://onco.cc/roadmaps/radiation-roadmap/)

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