BRAIN DAMAGE Study looks at oxygen

The study will look at adult patients whose survival options are limited.
CINCINNATI (AP) -- Patients who have suffered brain damage as a result of radiation treatments for brain tumors seem to show improvement after repeated sessions of breathing pure oxygen, a researcher said Thursday.
Dr. Laurie Gesell of University Hospital is leading a federally funded, two-year study designed to prove that patients with few other treatment options can stop or even reverse brain tissue damage or loss with one to three months of daily oxygen treatments.
Dr. Gesell said she applied for the $450,000 National Institutes of Health grant to test her observations that the oxygen treatments inside a hyperbaric chamber have helped other patients she has treated during the past six years.
The patients have brain damage or loss that interferes with speech, movement and strength and can ultimately result in death.
Dr. Gesell said that if the study, which involves 30 patients and ends in fall 2005, shows promise, it could lead to an expanded study involving other hospitals nationwide.
Dr. Gesell and three colleagues will begin analyzing data later this year.
What is known
Hyperbaric oxygen treatment is known to help patients who have suffered radiation injuries to bone or soft tissue. It is also used to treat patients with chronic infections, said Dr. Gesell, medical director for the hyperbaric medicine division of the University of Cincinnati's Department of Emergency Medicine.
Each year, about 160,000 brain tumors are diagnosed. Radiation therapy is often used to try to shrink and kill the tumor before it kills the patient.
Radiation treatment can cause a condition known as brain radiation necrosis. The injury can range from inflammation and swelling in brain tissue to the death of part of the brain.
Dr. Gesell's study focuses on adult patients who are getting sicker and are running out of options after having been placed on increasing doses of steroids to try and combat their brain swelling or inflammation.
High doses of steroids can damage organs or cause weight gain, and the ailing patient's only other option is surgery to remove a damaged brain portion -- if it's in an area accessible to a surgeon, Dr. Gesell said.
"Before these patients come to us, they're getting progressively worse," Dr. Gesell said. "If this is really working the way we think it's working, it could be really phenomenal for individuals all over the country."
Other experts agree that the study shows promise.
"I think it's definitely worth investigating because there's no other treatment for this radiation injury," said Dr. R. Loch Macdonald, a professor of neurosurgery at the University of Chicago.
Dr. Prabhakar Tripuraneni, head of radiation oncology at Scripps Clinic in La Jolla, Calif., uses hyperbaric treatments to help patients overcome jaw infections. He said the Cincinnati research could help if it demonstrates a similar benefit for healing brain tissue.
"It makes intuitive sense that it should work for brain necrosis," Dr. Tripuraneni said.
Of 40 patients treated in recent years, 91 percent had improvements in strength or sensation that physicians detected through weekly physical exams, Dr. Gesell said, quoting from an analysis done two years ago that she submitted to the NIH to obtain the study funding.
Magnetic resonance imaging scans showed that 78 percent either stabilized, improved or completely recovered from their injuries, she said.