Hyperbaric oxygen and radiotherapy: a Medical Research Council trial in carcinoma of the cervix

Abstract

In a randomized controlled clinical trial of hyperbaric oxygen in the radiotherapy of advanced carcinoma of the uterine cervix a total of 320 cases were contributed by four radiotherapy centres in the United Kingdom. The use of hyperbaric oxygen resulted in improved local control and survival. The benefit was greatest in patients under the age of 55 who presented with stage III disease. There was a slight increase in radiation morbidity but it seemed that the benefit of hyperbaric oxygen outweighed this increase in morbidity and that there was a true improvement in the therapeutic ratio.

Effects of radiotherapy after hyperbaric oxygenation on malignant gliomas

“…The previous combined method was a repetitive administration of irradiation during HBO exposure. In some clinical trials, significant improvements in local control and survival have been seen in cancers of head and neck, cervical region and uterine cervix (Henk et al, 1977;Watson et al, 1978;Henk, 1986), but no benefit has been demonstrated in patients with cancers of skin, bronchus and bladder (Sealy et al, 1974;Cade and McEwen, 1978). There are only two reports of human malignant gliomas treated with this therapeutic method (Chang, 1977;Dowling et al, 1992).…”

Oxygen-Enhanced MRI Is a Major Advance in Tumor Hypoxia Imaging

“…A meta-analysis of over 10,000 patients enrolled in nearly 90 randomized trials over the past 40 years revealed an OR of 0.77 in favor of hypoxia modification strategies (9). Phase III trials have been conducted utilizing radiotherapy with or without (i) increasing oxygen delivery with hyperbaric oxygen (10,11) or carbogen breathing with nicotinamide (12); (ii) the hypoxic cytotoxin, tirapazamine (13,14). Evofosfamide, another hypoxic cytotoxin, was found to yield improved survival in a randomized phase II trial when combined with gemcitabine in patients with pancreatic cancer (15).…”

Intermittent blood flow in the KHT sarcoma--flow cytometry studies using Hoechst 33342

“…Minchinton, R.E. Durand There is unequivocal evidence for the presence of radiobiologically hypoxic cells in experimental tumours (Moulder & Rockwell, 1984;Vaupel, 1979) and sound clinical evidence that they play an important role in determining the sensitivity to radiotherapy of some human tumours (Bush et al, 1978;Dische et al, 1983;Henk, 1986, Overgaard et al, 1986Watson et al, 1978). In addition, several studies indicate that sub-populations within tumours exhibit differential sensitivity to chemotherapeutic agents as a result of inherent sensitivity differences between aerobic and hypoxic cells (Teicher et al, 1981) and drug penetration problems (Kerr & Kaye, 1987).…”