[HYPERBARIC OXYGEN THERAPY (HBO) FOR RADIATION NECROSIS - PHYSICIAN AWARENESS IS REQUIRED]

Hyperbaric oxygen (HBO) therapy is the inhalation of 100% oxygen at a pressure of at least 1.4 atmospheres absolute (ATA), 140 kPa, in the hyperbaric chamber. The therapeutic effect is obtained by delivery of oxygen to the tissues dissolved in the plasma and independent of the hemoglobin. At an ambient chamber pressure of 2 to 2.4 ATA, the amount of plasma-dissolved oxygen can reach more than 6 vol %, which is sufficient to supply the body's basic metabolic requirements, while arterial PO2 can reach more than 2,000 mmHg. Under these conditions, oxygen catches up with and overtakes physics and physiology, enabling numerous physiological processes to take place. This includes angiogenesis in areas of reduced oxygen tension due to poor vascularity, increased collagen production, and edema reduction, among others. Such mechanisms promote wound healing and the recovery of radiation-injured tissue. HBO therapy has firm support in evidence-based medicine. The indications for treatment are approved by the Israel Ministry of Health and recognized by medical insurance providers. Nevertheless, lack of knowledge and insight make it necessary to heighten physician awareness of HBO as a safe procedure, and as the principal modality of treatment for radiation injury to otherwise healthy tissue.