Although, the BRC believes hyperbaric oxygen is helping to heal patients with brain radionecrosis, it is not understood why. Studies have not been done to compare brain radiation patients with hyperbaric oxygen treatments versus brain radiation patients without hyperbaric oxygen treatments. It is possible that the patients treated were actually helped by the steroids and not by the hyperbaric oxygen. Because this possibility has not been researched, the National Cancer Institute is supporting research at the Brain Radionecrosis Center comparing standard drug treatment for brain radionecrosis to drug treatment combined with hyperbaric oxygen therapy.

Patients who are not responding to steroids are candidates for this trial. These patients are normally treated with continued increasing dosages until steroid doses become excessive and surgery becomes necessary. The study will have two groups of patients:

     • Treated with ONLY steroids
     • Treated with hyperbaric oxygen AND steroids

Once a patient agrees to participate in the study, the Baseline examination will be performed including:

     • Various brain scans (MRI, PET)
     • Detailed neurologic assessment
     • Measurement of quality of life

The patient will then begin treatment for 90 days receiving either hyperbaric oxygen and steroids or steroids alone. Throughout the trial, the patient will be monitored closely with routine examinations (daily or weekly depending on patient needs)

at the Brain Radionecrosis Center. Complete examinations (similar to the Baseline visit) will be performed monthly during the treatments for both groups of patients. One week following the end of treatment, another complete examination will be performed, as well as one month, two months, and four months post treatment.

In addition to studying the effects of treatment, ten patients will be randomly chosen for specialized brain scans. The scans are designed to measure blood vessel growth which has been stimulated in the damaged parts of the brain. The scan will be performed before and after treatment, for these 10 patients.

Impact of the Research
The long-term goal of researchers at the Brain Radionecrosis Center is to expand treatment options for patients with brain radionecrosis. By understanding how the different therapies work, the BRC hopes to improve how brain radionecrosis is treated, improve patients' health, and lengthen life expectancy.

The current project is designed to understand how hyperbaric oxygen therapy works in brain radionecrosis. This research is significant because, if a reduction in brain injury and its symptoms can be demonstrated, another treatment option can be available to brain radionecrosis patients. In particular, this research could provide a treatment option for patients with inoperable brain radionecrosis that is not helped by steroids, a group of patients who currently have no treatment options.