Hyperbaric oxygen therapy: Can it prevent irradiation-induced necrosis?

Kuffler, Damién P.

doi:10.1016/j.expneurol.2012.03.011

Cited by 13 publications

(9 citation statements)

References 147 publications

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“…Compared to previous studies 24 25 26 27 , radiation cerebral necrosis is a common complication in radiotherapy of intracranial tumors. For a long time, the condition was treated symptomatically using hormones or measures such as hyperbaric oxygen; however, the efficacy of this treatment regimen was not satisfactory.…”

Section: Discussionmentioning

confidence: 76%

A study on the evaluation method and recent clinical efficacy of bevacizumab on the treatment of radiation cerebral necrosis

Zhuang

Yuan

Zheng

et al. 2016

Sci Rep

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In order to investigate the efficacy of bevacizumab on the treatment of radiation cerebral necrosis, patients who were diagnosed with radiation cerebral necrosis by imaging after stereotactic radiotherapy were collected. Bevacizumab was applied at a dose of 5 mg/kg once every three weeks at least three times. The changes in cerebral necrosis symptoms before and after treatment, the cerebral edema volume, the cerebral necrosis volume, and the changes in magnetic resonance imaging (MRI) strengthening phase signals of cerebral necrosis were used as the first observation point. The side effects of bevacizumab were used as the second observation point. Total of 14 radiation cerebral necrosis patients were treated with bevacizumab between June 2011 and February 2013 were collected. There were 12 symptomatic patients, of whom 10 patients (83.3%) had reduced symptoms. The edema index grades of nine patients (64.29%) improved. The cerebral necrosis volumes of 13 patients (92.86%) decreased. The T1 phase signal strengths of the intracranial enhanced MRIs of 12 patients (85.71%) significantly decreased. The clinical side effects of bevacizumab were mild. In conclusion, Preliminary results showed that treatment of radiation cerebral necrosis using bevacizumab was safe and effective. This treatment measure is worthy of further study.Radiation cerebral necrosis is a common complication after stereotactic radiotherapy of intracranial tumors. There are no treatment measures of this disease with significant long-term efficacy [1][2][3][4] . One of the important reasons for radiation cerebral necrosis is the vascular mechanism 5,6 . As an important anti-angiogenesis drug 7-9 , bevacizumab is a potential candidate for the treatment of radiation cerebral necrosis. This study summarized the preliminary efficacy of treatment of patients with radiation cerebral necrosis after stereotactic radiotherapy using bevacizumab in the Department of Radiology of the Tianjin Medical University Cancer Institute and Hospital to provide preliminary references for treatment of radiation cerebral necrosis. Materials and MethodsClinical information. This study was approved by the Tianjin Ethics Committee and was performed under its supervision. All experiments conformed to the ethics requirements, and all patients signed informed consent forms. The inclusion criteria of patients were patients with primary or metastatic intracranial lesions and had histories of cyberknife stereotactic radiotherapy for brain lesions and patients who were diagnosed with radiation cerebral necrosis by imaging or pathology. The data from a total of 14 patients (six males and eight females) who had radiation cerebral necrosis after stereotactic radiotherapy of primary or metastatic intracranial tumors and received bevacizumab between June 2011 and February 2013 were collected. The ages ranged between 31 and 70 years, and the median age was 53 years. There were zero cases of primary intracranial tumors and 14 cases of

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Section: Discussionmentioning

confidence: 76%

A study on the evaluation method and recent clinical efficacy of bevacizumab on the treatment of radiation cerebral necrosis

Zhuang

Yuan

Zheng

et al. 2016

Sci Rep

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“…Intravenous infusion of MSC caused in some patients disappearance of symptoms with no adverse effects but further studies are needed to confirm their efficiency [14]. HBO was introduced to improve the clinical state after radiation of various organs, including the bladder [5,[15][16][17]. Sufficient HBO therapy was described in both adult and pediatric patients [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of HBO is well known in HC after radiation. It induced proliferation of fibroblasts, promoted angiogenesis of capillaries, and stimulated the recovery of urothelium [4,5]. The most convenient group of patients for treatment with HBO consists of patients with BK virusassociated HC after allogenic human stem cell transplantations [2].…”

Section: Introductionmentioning

confidence: 99%

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

et al. 2015

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Hemorrhagic cystitis (HC) is a diffuse inflammation of the bladder of an infectious or non-infectious etiology, causing bleeding of the bladder mucosa. There are no explicit guidelines defining the appropriate treatment of HC. Hyperbaric oxygen therapy (HBO) is a non-invasive method involving the use of 100 % oxygen under increased pressure, which penetrates to poorly perfused areas. The most appropriate group for treatment with HBO is patients with BK virus-associated HC after allogenic human stem cell transplantation (alloHSCT). In this report, we present five patients after alloHSCT from a matched unrelated donor with symptoms of HC successfully treated with HBO. All patients received therapy with 100 % oxygen in a hyperbaric chamber at 2.5 atmospheres for 60 min, delivered 5 days per week. Complete response with resolution of pain and hematuria, as well as eradication of viral load, was achieved by all the patients after a mean of 13 sessions (range 11-30) of HBO. These data indicate that HBO therapy is sufficient and effective in the treatment of HC, and represents a well-tolerated procedure with good clinical and laboratory results after ineffective primary treatment.

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“…Oxygen is delivered at 20-24 atmospheres for 20-30 sessions, each session lasting 90-120 minutes [47]. The basis of the therapy is to increase oxygen concentration in ischemic areas and promote tissue healing via improved angiogenesis, thereby improving tissue perfusion and halting disease progression [4,44,48]. Whereas anti-VEGF therapy aims to prevent impaired angiogenesis from occurring altogether due to radiation-induced hypoxia, HBOT aims to improve VEGF-based angiogenesis by augmenting local oxygen delivery.…”

Section: Novel Therapiesmentioning

confidence: 99%

Radiation Necrosis in Intracranial Lesions

Munier

Ginalis

Patel

et al. 2020

Cureus

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Radiation necrosis (RN) is a challenging potential complication of cranial radiation therapy. Believed to result from a complex interplay of vascular, glial, and immunologic factors, the exact mechanism of RN remains unclear. Patients who develop RN typically have a history of treatment with stereotactic radiation surgery or some other form of radiation-based therapy. The time frame for its development is variable, but it most often occurs one to three years following radiation therapy. Reported treatment doses capable of inducing radiation necrosis are variable, with higher doses per fraction more likely to induce RN. Furthermore, RN remains a challenging diagnosis for clinicians to make, as its presentation is often nonspecific and imaging studies might not clearly differentiate RN from tumor recurrence or pseudoprogression. RN is initially managed with corticosteroids, followed by bevacizumab, surgical resection, or laser interstitial thermal therapy if symptoms persist. In this review, we examine the literature regarding pathophysiology, incidence, imaging characteristics, and management strategies for radiation necrosis.

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Hyperbaric oxygen therapy: Can it prevent irradiation-induced necrosis?

Cited by 13 publications

References 147 publications

A study on the evaluation method and recent clinical efficacy of bevacizumab on the treatment of radiation cerebral necrosis

A study on the evaluation method and recent clinical efficacy of bevacizumab on the treatment of radiation cerebral necrosis

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

Radiation Necrosis in Intracranial Lesions

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