Hyperbaric oxygen therapy for late radiation tissue injury

Lin, Zhiliang Caleb; Bennett, Michael H; Hawkins, Glen C; Azzopardi, Charles Paul; Feldmeier, John; Smee, Robert; Milross, Christopher

doi:10.1002/14651858.cd005005.pub5

Cited by 9 publications

(6 citation statements)

References 62 publications

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“…This study supports the efficacy and safety of HBO 2 for managing RC and highlights the need for further data collection to determine the optimal treatment protocol, treatment duration, and a Due to 2 significant digit specification, total cohort percent may not add up to 100. patient selection factors for this minimally invasive intervention. 26 Prior work evaluating HBO 2 has focused on outcomes such as reducing blood transfusion rates or avoiding the need for cystectomy and urinary diversion. 7,27,28 Recent studies include the importance of patient perceived impact on urinary function.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Outcome Measures Following Hyperbaric Oxygen Therapy for Radiation Cystitis: Early Results From the Multicenter Registry for Hyperbaric Oxygen Therapy

Moses,

Hunter,

Brandes

et al. 2024

Journal of Urology

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Purpose: Our purpose was to determine changes in patient-reported hematuria and urinary symptoms after hyperbaric oxygen (HBO 2 ) treatment for radiation cystitis (RC). Materials and Methods: We analyzed prospectively collected data from the Multicenter Registry for Hyperbaric Oxygen Therapy Consortium accumulated within a week of beginning and ending HBO 2 . Measures included the modified Radiation Therapy Oncology Group (RTOG) Hematuria Scale, Urinary Distress Inventory Short Form, and EuroQol Five Dimension Five Level instrument. RTOG hematuria and Urinary Distress Inventory Short Form scores were compared using the sign test. Logistic regression was used to evaluate characteristics associated with hematuria improvement.

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Section: Discussionmentioning

confidence: 99%

Patient-Reported Outcome Measures Following Hyperbaric Oxygen Therapy for Radiation Cystitis: Early Results From the Multicenter Registry for Hyperbaric Oxygen Therapy

Moses,

Hunter,

Brandes

et al. 2024

Journal of Urology

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“…The data presented did not reveal -as expected -a beneficial clinical effect of using HBOT in treating ORNM. However, some criticisms were made (including in a Cochrane review) 1,5,43,44 to this trial, namely:…”

Section: Hyperbaric Oxygen Therapymentioning

confidence: 99%

Hyperbaric Oxygen Therapy as a Complementary Treatment for Osteoradionecrosis of the Mandible: Useless or Useful? - A Literature Review

Alpuim Costa,

Arana Ribeiro,

D'Espiney Amaro

2024

Gaz Med

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Radiotherapy (RT) is a key component of managing head and neck cancer patients. However, despite the emer gence and improvement of new RT techniques, late complications may occur, such as osteoradionecrosis of the mandible (ORNM). The diagnosis is based on clinical/radiological criteria. In the established ORNM, the chronic process does not solve spontaneously, and optimal management still needs to be established. Over the last decades, a broad therapeutic spectrum has been considered, including hyperbaric oxygen therapy (HBOT). Al though, the clinical impact of HBOT varies according to the literature, which is why there is a current controversy regarding its benefits. Further prospective and randomised studies are needed to validate its effectiveness in the ‘real-world’ clinical practice. This article aims to synthesise the existing data, analyse previous studies´ results, identify gaps in knowledge, and discuss ORNM’ management, including a proposal for an algorithm, with a par t icular focus on HBOT.

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“…The Cochrane Network recently updated their systematic review for HBOT use for late radiation toxicity. 7 They conclude that some evidence exists that HBOT could significantly improve late radiation toxicity generally but with low-certainty evidence due to high attrition rate and a high risk of bias. They highlight the need for better evidence through randomized clinical trials and also make note of several considerations to generate high-quality evidence, including an effective sham control and appropriate blinding of assessors.…”

mentioning

confidence: 99%

“…The Cochrane Network recently updated their systematic review for HBOT use for late radiation toxicity . They conclude that some evidence exists that HBOT could significantly improve late radiation toxicity generally but with low-certainty evidence due to high attrition rate and a high risk of bias.…”

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confidence: 99%

Hyperbaric Oxygen Therapy for Management of Late Radiation Toxicity—A Honey of a Trial?

Hahn,

Popovtzer,

Corn

2024

JAMA Oncol

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Hyperbaric oxygen therapy (HBOT) represents a modality of interest to many oncologists, even if not well understood and seldom used by many in practice. To the radiation oncologist in particular, and to patients who experience late toxicities of radiotherapy such as fibrosis and pain, HBOT offers an ember of hope in the desperate attempt to treat these chronic adverse effects of therapy. The US Food and Drug Administration has cleared HBOT for marketing in the framework of regulated medical devices for several conditions, such as nonhealing wounds, decompression sickness, and radiation injury. 1 Work is also ongoing to determine efficacy of HBOT in diverse scenarios ranging from a priori radiation sensitization to chronic fatigue syndrome and from early use to use only in desperate situations. 2 However, the agency cautions clinicians to be wary of unproven claims of effect, perhaps highlighting the vulnerability of patients seeking therapy for some of the most troubling ailments. Moreover, there is concern that the burgeoning industry of HBOT might include unscrupulous centers since only 154 facilities in the United States, out of well over 1000, are accredited by the Undersea and Hyperbaric Medical Society, 3 and findings of misuse have been previously documented. 4 In JAMA Oncology, Mink van der Molen et al 5 report results of the Effect of Hyperbaric Oxygen Therapy on Breast Cancer Patients With Late Radiation Toxicity (HONEY) trial, generating the best evidence to date for prescribing HBOT to treat late toxicities of breast radiotherapy. The authors use a creative study design, drawing from a larger cohort of patients with breast cancer who have already consented to prospective quality of life data collection. 6 This cohort had previously provided additional consent to partake in randomized trials of unknown future interventions, with further consent required for particular interventions if randomized to the experimental arm. However, if randomized to the control arm, patients were neither informed nor was their further consent required, and their data served as the control. Within this structure, the HONEY investigators identified patients treated for breast cancer at least 12 months after radiotherapy who reported moderate/severe breast, chest wall, and/or shoulder pain in combination with at least 1 symptom of mild/moderate/severe fibrosis, breast edema, and/or movement restriction, based on questionnaire responses. The intervention was an invitation to HBOT, in which patients breathed 100% oxygen during 4 intervals of 20 minutes in a 2-hour session, for 30 to 40 sessions, spanning 6 to 8 weeks. Patients were categorized as HBOT adherent if they participated in treatment and categorized as HBOT nonadherent if they attended less than 7 sessions or declined treatment.

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Hyperbaric oxygen therapy for late radiation tissue injury

Cited by 9 publications

References 62 publications

Patient-Reported Outcome Measures Following Hyperbaric Oxygen Therapy for Radiation Cystitis: Early Results From the Multicenter Registry for Hyperbaric Oxygen Therapy

Patient-Reported Outcome Measures Following Hyperbaric Oxygen Therapy for Radiation Cystitis: Early Results From the Multicenter Registry for Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy as a Complementary Treatment for Osteoradionecrosis of the Mandible: Useless or Useful? - A Literature Review

Hyperbaric Oxygen Therapy for Management of Late Radiation Toxicity—A Honey of a Trial?

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