A Randomized, Double-Blind, Crossover Trial of the Effect of Oxygen on Dyspnea in Patients with Advanced Cancer

Philip, Jennifer; Gold, Michelle; Milner, Alvin; Iulio, Juliana Di; Miller, Bruce W.

doi:10.1016/j.jpainsymman.2006.06.009

Cited by 85 publications

(104 citation statements)

References 31 publications

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“…Studies that did not include cancer patients were excluded from this analysis. The five abstracted articles represent data from five different studies (Table 1; Bruera et al, 1993Bruera et al, , 2003Booth et al, 1996;Ahmedzai et al, 2004;Philip et al, 2006).…”

Section: Article Reviewmentioning

confidence: 99%

“…The profile of other malignancies was as follows: breast (5%), colon (3%), and others, including lymphoma, melanoma, sarcoma, carcinoid, skin, bladder, and head and neck (7%). Baseline percent oxygen saturation that was provided by four out of five studies are as follows: median 93% (Philip et al, 2006), median 94% (Ahmedzai et al, 2004), median 98% (Bruera et al, 2003), and range 80 -99% (Booth et al, 1996). Baseline dyspnoea at rest that was provided in three out of five studies are as follows: 0 mm by modified Borg (Ahmedzai et al, 2004), 5 mm by NRS (Bruera et al, 2003), and 59 mm by 100 mm VAS (Booth et al, 1996).…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Intervention characteristics Four studies (Bruera et al, 1993(Bruera et al, , 2003Booth et al, 1996;Philip et al, 2006) were focused on evaluating oxygen vs medical air for relief of dyspnoea, whereas the fourth evaluated the use of Heliox28, a novel agent containing 72% helium and 28% oxygen vs oxygen and medical air (Ahmedzai et al, 2004). Oxygen was delivered by nasal canula in three studies (Booth et al, 1996;Bruera et al, 2003;Philip et al, 2006) and by mask in two (Bruera et al, 1993;Ahmedzai et al, 2004); doses of oxygen ranged from 3 to 5 l min À1 .…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Oxygen was delivered by nasal canula in three studies (Booth et al, 1996;Bruera et al, 2003;Philip et al, 2006) and by mask in two (Bruera et al, 1993;Ahmedzai et al, 2004); doses of oxygen ranged from 3 to 5 l min À1 . Oxygen was administered at rest in three studies (Bruera et al, 1993;Booth et al, 1996;Philip et al, 2006) and during a 6MWT (6-min walk test) in two studies (Bruera et al, 2003;Ahmedzai et al, 2004).…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…As a result, all the authors were contacted to request individual patient data. All the authors responded; individual patient data were available for three studies (Booth et al, 1996;Bruera et al, 2003;Philip et al, 2006) and were unavailable for the other two (Bruera et al, 1993;Ahmedzai et al, 2004). Using correlations calculated from available data, it was possible to derive s.e.…”

Section: Treatment Efficacymentioning

confidence: 99%

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Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis

et al. 2008

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The aim of this study was to determine the efficacy of palliative oxygen for relief of dyspnoea in cancer patients. MEDLINE and EMBASE were searched for randomised controlled trials, comparing oxygen and medical air in cancer patients not qualifying for home oxygen therapy. Abstracts were reviewed and studies were selected using Cochrane methodology. The included studies provided oxygen at rest or during a 6-min walk. The primary outcome was dyspnoea. Standardised mean differences (SMDs) were used to combine scores. Five studies were identified; one was excluded from meta-analysis due to data presentation. Individual patient data were obtained from the authors of the three of the four remaining studies (one each from England, Australia, and the United States). A total of 134 patients were included in the meta-analysis. Oxygen failed to improve dyspnoea in mildly-or non-hypoxaemic cancer patients (SMD ¼ À0.09, 95% confidence interval À0.22 to 0.04; P ¼ 0.16). Results were stable to a sensitivity analysis, excluding studies requiring the use of imputed quantities. In this small meta-analysis, oxygen did not provide symptomatic benefit for cancer patients with refractory dyspnoea, who would not normally qualify for home oxygen therapy. Further study of the use of oxygen in this population is warranted given its widespread use.

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Section: Article Reviewmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Treatment Efficacymentioning

confidence: 99%

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Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis

et al. 2008

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Nonpharmacological Interventions for Managing Breathlessness in Patients With Advanced Cancer

et al. 2021

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IMPORTANCE Breathlessness is a frequent and debilitating symptom in patients with advanced cancer. Often, in the context of breathlessness, aggressive cancer treatment is not beneficial, feasible, or aligned with goals of care. Targeted symptom-focused interventions may be helpful in this scenario.OBJECTIVE To evaluate the advantages and harms of nonpharmacological interventions for managing breathlessness in adults with advanced cancer.EVIDENCE REVIEW PubMed, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception through May 2020 for published randomized clinical trials (RCTs), nonrandomized controlled trials, and observational studies of the advantages and/or harms of nonpharmacological interventions on alleviating breathlessness in adults with advanced cancer. Only English-language studies were screened for eligibility, titles, abstracts, and full text. Risk of bias and strength of evidence (SOE) were independently assessed. The key outcomes reported in studies were breathlessness, anxiety, exercise capacity, health-related quality of life, and harms. Data were analyzed from October 1, 2019, to June 30, 2020.FINDINGS A total of 29 RCTs (2423 participants) were included. These RCTs evaluated various types of interventions, such as respiratory (9 RCTs), activity and rehabilitation (7 RCTs), behavioral and psychoeducational (3 RCTs), integrative medicine (4 RCTs), and multicomponent (6 RCTs). Several nonpharmacological interventions were associated with improved breathlessness, including fan therapy (standardized mean difference [SMD], −2.09; 95% CI, −3.81 to −0.37; I 2 = 94.3%; P for heterogeneity = .02; moderate SOE) and bilevel ventilation (estimated slope difference, −0.58; 95% CI, −0.92 to −0.23; low SOE), lasting for a few minutes to hours, in the inpatient setting. In the outpatient setting, nonpharmacological interventions associated with improved breathlessness were acupressure and reflexology (integrative medicine) (low SOE) and multicomponent interventions (combined activity and rehabilitation, behavioral and psychoeducational, and integrative medicine) (low SOE) lasting for a few weeks to months. Five of the 29 RCTs (17%) reported adverse events, although adverse events and study dropouts were uncommon.CONCLUSIONS AND RELEVANCE Findings of this review include the safety and association with improved breathlessness of several nonpharmacological interventions for adults with advanced cancer. Guidelines and clinical practice should evolve to incorporate nonpharmacological interventions as first-line treatment for adults with advanced cancer and breathlessness.

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The Management of Respiratory Symtpoms and Advanced COPD

Jones

2012

Handbook of Palliative Care

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A Randomized, Double-Blind, Crossover Trial of the Effect of Oxygen on Dyspnea in Patients with Advanced Cancer

Cited by 85 publications

References 31 publications

Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis

Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis

Nonpharmacological Interventions for Managing Breathlessness in Patients With Advanced Cancer

The Management of Respiratory Symtpoms and Advanced COPD

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