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Supportive Care in Cancer

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01.06.2014 | Review Article

Systematic review of hyperbaric oxygen therapy for the treatment of non-neurological soft tissue radiation-related injuries

verfasst von: Benjamin L. Hoggan, Alun L. Cameron

Erschienen in: Supportive Care in Cancer | Ausgabe 6/2014

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Abstract

Purpose

The purpose of this paper was to provide an evidence-based evaluation of the safety and effectiveness of hyperbaric oxygen therapy (HBOT) for the treatment of non-neurological soft tissue radiation-related injuries (STRI).

Methods

Systematic searches of medical bibliographic databases, the Internet, and lists of references were conducted in December 2010 and April 2013 to identify relevant primary studies. Inclusion and classification of papers was resolved through the application of a predetermined protocol. Information on both the safety and effectiveness of HBOT was analyzed.

Results

Forty-one articles were included, with 11 comparing HBOT to a regimen without HBOT. Comparative evidence varied considerably in methodological quality, and numerous limitations were identified. Absolute data showed that serious adverse events after HBOT were rare, while more common adverse events were minor and self-limiting. Compared to observation, conventional, or sham therapies, evidence of benefit in clinical outcomes was shown for HBOT for radiation proctitis and wounds in irradiated soft tissue of the head and neck, but not for postirradiation soft tissue edema or radiation cystitis. Clinical outcomes differed little between HBOT and argon plasma coagulation for radiation proctitis and between HBOT and hyaluronic acid for radiation cystitis.

Conclusions

HBOT is a safe intervention which may offer clinical benefits to patients suffering from radiation proctitis and non-neurological STRI of the head and neck. However, differing clinical responses across STRI demonstrate a need for further well-designed clinical trials to validate the use of HBOT for individual STRI, both as an adjunct to conventional treatments and relative to definitive treatments.

Pasquier D, Hoelscher T, Schmutz J, Dische S, Mathieu D, Baumann M, Lartigau E (2004) Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues: a literature review. Radiother Oncol 72(1):1–13PubMedCrossRef

Stone HB, Coleman CN, Anscher MS, McBride WH (2003) Effects of radiation on normal tissue: consequences and mechanisms. Lancet Oncol 4(9):529–536PubMedCrossRef

Feldmeier JJ (2004) Hyperbaric oxygen for delayed radiation injuries. Undersea Hyperb Med 31(1):133–145PubMed

Phan J, Swanson DA, Levy LB, Kudchadker RJ, Bruno TL, Frank SJ (2009) Late rectal complications after prostate brachytherapy for localized prostate cancer: incidence and management. Cancer 115(9):1827–1839PubMedCrossRef

August M, Wang J, Plante D, Wang CC (1996) Complications associated with therapeutic neck radiation. J Oral Maxillofac Surg 54(12):1409–1415PubMedCrossRef

Marx RE, Johnson RP (1987) Studies in the radiobiology of osteoradionecrosis and their clinical significance. Oral Surg Oral Med Oral Pathol 64(4):379–390PubMedCrossRef

Yeoh EE, Holloway RH, Fraser RJ, Botten RJ, Di Matteo AC, Moore JW, Schoeman MN, Bartholomeusz FD (2004) Anorectal dysfunction increases with time following radiation therapy for carcinoma of the prostate. Am J Gastroenterol 99(2):361–369PubMedCrossRef

Allen S, Kilian C, Phelps J, Whelan HT (2012) The use of hyperbaric oxygen for treating delayed radiation injuries in gynecologic malignancies: a review of literature and report of radiation injury incidence. Support Care Cancer 20(10):2467–2472PubMedCrossRef

Shibuya H (2009) Current status and perspectives of brachytherapy for head and neck cancer. Int J Clin Oncol 14(1):2–6PubMedCrossRef

10.

Bennett MH, Feldmeier J, Hampson N, Smee R, Milross C (2012) Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Syst Rev 5, CD005005

11.

Wang C, Schwaitzberg S, Berliner E, Zarin DA, Lau J (2003) Hyperbaric oxygen for treating wounds: a systematic review of the literature. Arch Surg 138(3):272–279PubMedCrossRef

12.

Marx RE, Ehler WJ, Tayapongsak P, Pierce LW (1990) Relationship of oxygen dose to angiogenesis induction in irradiated tissue. Am J Surg 160(5):519–524PubMedCrossRef

13.

Marx RE, Johnson RP, Kline SN (1985) Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin. J Am Dent Assoc 111(1):49–54PubMed

14.

Feldmeier JJ, Hampson NB (2002) A systematic review of the literature reporting the application of hyperbaric oxygen prevention and treatment of delayed radiation injuries: an evidence based approach. Undersea Hyperb Med 29(1):4–30PubMed

15.

Medical Services Advisory Committee (2004) Hyperbaric oxygen therapy for the treatment of non-healing, refractory wounds in non-diabetic patients and refractory soft tissue radiation injuries. MSAC application 1054. Assessment report. Medical Services Advisory Committee (MSAC), Canberra

16.

Boudreau R, Moulton K, McGill S (2010) Hyperbaric oxygen therapy for difficult wound healing: systematic review of clinical effectiveness and cost-effectiveness. Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa

17.

Cancer Care Ontario (2005) Hyperbaric oxygen therapy for the treatment and prevention of radionecrosis and other radiation-induced injuries in cancer patients. Cancer Care Ontario (CCO), Toronto

18.

De Laet C, Obyn C, Ramaekers D, Van de Sande S, Neyt M (2008) Hyperbaric oxygen therapy: a rapid assessment. Belgian Health Care Knowledge Centre (KCE), Brussels

19.

Denton A, Forbes A, Andreyev J, Maher EJ (2002) Non surgical interventions for late radiation proctitis in patients who have received radical radiotherapy to the pelvis. Cochrane Database Syst Rev 1, CD003455

20.

Denton AS, Clarke N, Maher J (2002) Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis. Cochrane Database Syst Rev Issue 3, CD001773

21.

Guo S, Counte MA, Romeis JC (2003) Hyperbaric oxygen technology: an overview of its applications, efficacy, and cost-effectiveness. Int J Technol Assess Health Care 19(2):339–346PubMedCrossRef

22.

Raman G, Kupelnick B, Chew P, Lau J (2006) A horizon scan: uses of hyperbaric oxygen therapy. Agency for Healthcare Research and Quality (AHRQ), Rockville

23.

Ritchie K, Baxter S, Craig J, Macpherson K, Mandava L, McIntosh H, Wilson S (2008) The clinical and cost effectiveness of hyperbaric oxygen therapy. National Health Service Quality Improvement Scotland (NHS QIS), Glasgow, Scotland

24.

Hoggan B, Cronin P, Cameron A, Goodall S (2011) Hyperbaric oxygen therapy for the treatment of chronic non-diabetic wounds and non-neurological soft tissue radiation injuries. MSAC application 1054.1. Assessment report. Commonwealth of Australia, Canberra

25.

National Health and Medical Research Council (2009) NHMRC levels of evidence and grades for recommendations for developers of guidelines. National Health and Medical Research Council (NHMRC), Canberra

26.

Higgins JPT, Green S (eds) (2011) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration

27.

Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, Gøtzsche PC, Lang T (2001) The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med 134(8):663–694PubMedCrossRef

28.

Clarke RE, Tenorio LM, Hussey JR, Toklu AS, Cone DL, Hinojosa JG, Desai SP, Dominguez PL, Rodrigues SD, Long RJ, Walker MB (2008) Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long-term follow-up. Int J Radiat Oncol Biol Phys 72(1):134–143PubMedCrossRef

29.

Gothard L, Haviland J, Bryson P, Laden G, Glover M, Harrison S, Woods M, Cook G, Peckitt C, Pearson A, Somaiah N, Stanton A, Mortimer P, Yarnold J (2010) Randomised phase II trial of hyperbaric oxygen therapy in patients with chronic arm lymphoedema after radiotherapy for cancer. Radiother Oncol 97(1):101–107PubMedCrossRef

30.

Marx RE (1999) Radiation injury to tissue. In: Kindwall EP, Whelan HT (eds) Hyperbaric Medicine Practice, 2nd edn. Best Publishing Company, Flagstaff, pp 682–687

31.

Shao Y, Lu GL, Shen ZJ (2012) Comparison of intravesical hyaluronic acid instillation and hyperbaric oxygen in the treatment of radiation-induced hemorrhagic cystitis. BJU Int 109(5):691–694PubMedCrossRef

32.

Sidik S, Hardjodisastro D, Setiabudy R, Gondowiardjo S (2007) Does hyperbaric oxygen administration decrease side effect and improve quality of life after pelvic radiation? Acta Med Indones 39(4):169–173PubMed

33.

Sidik S, Hardjodisastro D, Setiabudy R, Gondowiardjo S, Yoewono V (2007) Oxygen hyperbaric therapy in patients with radiation proctitis. Indones J Gastroenterol Hepatol Dig Endosc 8(1):1–4

34.

Alvaro-Villegas JC, Sobrino-Cossio S, Tenorio-Tellez LC, de la Mora-Levy JG, Hernandez-Guerrero A, Alonso-Larraga JO, Vela-Chavez T (2011) Argon plasma coagulation and hyperbaric oxygen therapy in chronic radiation proctopathy, effectiveness and impact on tissue toxicity. Rev Esp Enferm Dig 103(11):576–581PubMedCrossRef

35.

Carl UM, Feldmeier JJ, Schmitt G, Hartmann KA (2001) Hyperbaric oxygen therapy for late sequelae in women receiving radiation after breast-conserving surgery. Int J Radiat Oncol Biol Phys 49(4):1029–1031PubMedCrossRef

36.

Mohamad Al-Ali B, Trummer H, Shamloul R, Zigeuner R, Pummer K (2010) Is treatment of hemorrhagic radiation cystitis with hyperbaric oxygen effective? Urol Int 84(4):467–470PubMedCrossRef

37.

Neovius EB, Lind MG, Lind FG (1997) Hyperbaric oxygen therapy for wound complications after surgery in the irradiated head and neck: a review of the literature and a report of 15 consecutive patients. Head Neck 19(4):315–322PubMedCrossRef

38.

Abratt RP, Mills EE (1978) The use of hyperbaric oxygen as an adjunct in the treatment of radionecrosis. S Afr Med J 54(17):697–699PubMed

39.

Ashamalla HL, Thom SR, Goldwein JW (1996) Hyperbaric oxygen therapy for the treatment of radiation-induced sequelae in children. The University of Pennsylvania experience. Cancer 77(11):2407–2412PubMedCrossRef

40.

Bevers RF, Bakker DJ, Kurth KH (1995) Hyperbaric oxygen treatment for haemorrhagic radiation cystitis. Lancet 346(8978):803–805PubMedCrossRef

41.

Chavez JA, Adkinson CD (2001) Adjunctive hyperbaric oxygen in irradiated patients requiring dental extractions: outcomes and complications. J Oral Maxillofac Surg 59(5):518–522PubMedCrossRef

42.

Dall'Era MA, Hampson NB, Hsi RA, Madsen B, Corman JM (2006) Hyperbaric oxygen therapy for radiation induced proctopathy in men treated for prostate cancer. J Urol 176(1):87–90PubMed

43.

Feldmeier JJ, Heimbach RD, Davolt DA, Brakora MJ (1993) Hyperbaric oxygen as an adjunctive treatment for severe laryngeal necrosis: a report of nine consecutive cases. Undersea Hyperb Med 20(4):329–335PubMed

44.

Feldmeier JJ, Heimbach RD, Davolt DA, Court WS, Stegmann BJ, Sheffield PJ (1996) Hyperbaric oxygen an adjunctive treatment for delayed radiation injuries of the abdomen and pelvis. Undersea Hyperb Med 23(4):205–213PubMed

45.

Ferguson BJ, Hudson WR, Farmer JC Jr (1987) Hyperbaric oxygen therapy for laryngeal radionecrosis. Ann Otol Rhinol Laryngol 96(1 Pt 1):1–6PubMed

46.

Filntisis GA, Moon RE, Kraft KL, Farmer JC, Scher RL, Piantadosi CA (2000) Laryngeal radionecrosis and hyperbaric oxygen therapy: report of 18 cases and review of the literature. Ann Otol Rhinol Laryngol 109(6):554–562PubMed

47.

Fink D, Chetty N, Lehm JP, Marsden DE, Hacker NF (2006) Hyperbaric oxygen therapy for delayed radiation injuries in gynecological cancers. Int J Gynecol Cancer 16(2):638–642PubMedCrossRef

48.

Girnius S, Cersonsky N, Gesell L, Cico S, Barrett W (2006) Treatment of refractory radiation-induced hemorrhagic proctitis with hyperbaric oxygen therapy. Am J Clin Oncol 29(6):588–592PubMedCrossRef

49.

Hampson NB, Holm JR, Wreford-Brown CE, Feldmeier J (2012) Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury. Cancer 118(15):3860–3868PubMedCrossRef

50.

Hart GB, Mainous EG (1976) The treatment of radiation necrosis with hyperbaric oxygen (OHP). Cancer 37(6):2580–2585PubMedCrossRef

51.

Jones K, Evans AW, Bristow RG, Levin W (2006) Treatment of radiation proctitis with hyperbaric oxygen. Radiother Oncol 78(1):91–94PubMedCrossRef

52.

Kaur J, Hay KD, MacDonald H, Rich AM (2009) Retrospective audit of the use of the Marx Protocol for prophylactic hyperbaric oxygen therapy in managing patients requiring dental extractions following radiotherapy to the head and neck. N Z Dent J 105(2):47–50PubMed

53.

Lee HC, Liu CS, Chiao C, Lin SN (1994) Hyperbaric oxygen therapy in hemorrhagic radiation cystitis: a report of 20 cases. Undersea Hyperb Med 21(3):321–327PubMed

54.

Marshall GT, Thirlby RC, Bredfeldt JE, Hampson NB (2007) Treatment of gastrointestinal radiation injury with hyperbaric oxygen. Undersea Hyperb Med 34(1):35–42PubMed

55.

Mayer R, Klemen H, Quehenberger F, Sankin O, Mayer E, Hackl A, Smolle-Juettner FM (2001) Hyperbaric oxygen—an effective tool to treat radiation morbidity in prostate cancer. Radiother Oncol 61(2):151–156PubMedCrossRef

56.

Neheman A, Nativ O, Moskovitz B, Melamed Y, Stein A (2005) Hyperbaric oxygen therapy for radiation-induced haemorrhagic cystitis. BJU Int 96(1):107–109PubMedCrossRef

57.

Norkool DM, Hampson NB, Gibbons RP, Weissman RM (1993) Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis. J Urol 150(2 Pt 1):332–334PubMed

58.

Oliai C, Fisher B, Jani A, Wong M, Poli J, Brady LW, Komarnicky LT (2012) Hyperbaric oxygen therapy for radiation-induced cystitis and proctitis. Int J Radiat Oncol Biol Phys 84(3):733–740PubMedCrossRef

59.

Parra C, Gómez R, Marchetti P, Rubio G, Felmer A, Castillo OA (2011) Management of hemorrhagic radiation cystitis with hyperbaric oxygen therapy. Actas Urol Esp 35(3):175–179PubMedCrossRef

60.

Rijkmans BG, Bakker DJ, Dabhoiwala NF, Kurth KH (1989) Successful treatment of radiation cystitis with hyperbaric oxygen. Eur Urol 16(5):354–356PubMed

61.

Safra T, Gutman G, Fishlev G, Soyfer V, Gall N, Lessing JB, Almog R, Matcievsky D, Grisaru D (2008) Improved quality of life with hyperbaric oxygen therapy in patients with persistent pelvic radiation-induced toxicity. Clin Oncol (R Coll Radiol) 20(4):284–287CrossRef

62.

Shilo Y, Efrati S, Simon Z, Sella A, Gez E, Fenig E, Wygoda M, Lindner A, Fishlev G, Stav K, Zisman A, Siegel YI, Leibovici D (2013) Hyperbaric oxygen therapy for hemorrhagic radiation cystitis. Isr Med Assoc J 15(2):75–78PubMed

63.

Waring A, Oxer H (2000) Hyperbaric oxygen therapy for radiation-induced haemorrhagic cystitis. SPUMS J 30(4):186–190

64.

Williams JA Jr, Clarke D, Dennis WA, Dennis EJ III, Smith ST (1992) The treatment of pelvic soft tissue radiation necrosis with hyperbaric oxygen. Am J Obstet Gynecol 167(2):412–415PubMedCrossRef

65.

Woo TC, Joseph D, Oxer H (1997) Hyperbaric oxygen treatment for radiation proctitis. Int J Radiat Oncol Biol Phys 38(3):619–622PubMedCrossRef

66.

Yoshida T, Kawashima A, Ujike T, Uemura M, Nishimura K, Miyoshi S (2008) Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis. Int J Urol 15(7):639–641PubMedCrossRef

67.

Yu SY, Chen ST, Chan SE, Kuo SJ, Niu KC (2002) Hyperbaric oxygen therapy for late sequelae of breast irradiation. Formos J Surg 35(4):209–214

68.

Agence d’évaluation des technologies et des modes d’intervention en santé (2001) Hyberbaric oxygen therapy in Québec (AÉTMIS 2000–3 RE). Agence d’évaluation des technologies et des modes d’intervention en santé (AETMIS), Montréal

69.

Craighead P, Shea-Budgell MA, Nation J, Esmail R, Evans AW, Parliament M, Oliver TK, Hagen NA (2011) Hyperbaric oxygen therapy for late radiation tissue injury in gynecologic malignancies. Curr Oncol 18(5):220–227PubMedCentralPubMedCrossRef

70.

Gibson RJ, Keefe DM, Lalla RV, Bateman E, Blijlevens N, Fijlstra M, King EE, Stringer AM, van der Velden WJ, Yazbeck R, Elad S, Bowen JM (2012) Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. Support Care Cancer 21(1):313–326PubMedCrossRef

71.

Nabil S, Samman N (2011) Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. Int J Oral Maxillofac Surg 40(3):229–243PubMedCrossRef

72.

Nakada T, Nakada H, Yoshida Y, Nakashima Y, Banya Y, Fujihira T, Karasawa K (2012) Hyperbaric oxygen therapy for radiation cystitis in patients with prostate cancer: a long-term follow-up study. Urol Int 89(2):208–214PubMedCrossRef

73.

Del Pizzo JJ, Chew BH, Jacobs SC, Sklar GN (1998) Treatment of radiation induced hemorrhagic cystitis with hyperbaric oxygen: long-term follow up. J Urol 160(3 Pt 1):731–733PubMed

74.

Clarke D (2009) Effective patient blinding during hyperbaric trials. Undersea Hyperb Med 36(1):13–17PubMed

75.

Schulz KF, Chalmers I, Hayes RJ, Altman DG (1995) Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 273(5):408–412PubMedCrossRef

76.

Lambertsen CJ (1965) Effects of oxygen at high partial pressure. In: Fenn WO, Rahn H (eds) Handbook of physiology. Section 3: Respiration, vol 2. American Physiological Society, Washington DC, pp 1027–1046

77.

Gomez-Castillo JD, Bennett MH (2005) The cost of hyperbaric therapy at the Prince of Wales Hospital, Sydney. SPUMS J 35(4):194–198

78.

Welslau W, Laak U (2000) Disapproval of HBO by German health care system. Hyperb Med Today 1:20–22

79.

Medical Services Advisory Committee (2012) Public summary document. Reconsideration of application 1054.1: hyperbaric oxygen treatment (HBOT) for non-diabetic chronic wounds. Medical Services Advisory Committee (MSAC), Canberra

80.

Cronin P, Hoggan B, Goodall S, Cameron A (2012) CE3 Hyperbaric oxygen therapy for the treatment non-neurological soft tissue radiation injuries—a cost-effectiveness analysis. Value Health 15(7):A602CrossRef

81.

ClinicalTrials.gov (2005) Identifier NCT00134628: Study to determine if hyperbaric oxygen therapy is helpful for treating radiation tissue injuries. National Library of Medicine (US). http://clinicaltrials.gov/show/NCT00134628. Accessed 17 June 2013

Titel: Systematic review of hyperbaric oxygen therapy for the treatment of non-neurological soft tissue radiation-related injuries
verfasst von: Benjamin L. Hoggan
Alun L. Cameron
Publikationsdatum: 01.06.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 6/2014
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-014-2198-z

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Systematic review of hyperbaric oxygen therapy for the treatment of non-neurological soft tissue radiation-related injuries

Abstract

Purpose

Methods

Results

Conclusions

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