Hyperbaric oxygen therapy for late radiation tissue injury

Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, Barker Street, Randwick, New South Wales, Australia, 2031.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2005; 5(3):CD005005. DOI: 10.1002/14651858.CD005005.pub2
Source: PubMed


There is a risk of serious complications developing after radiation treatment for cancer (late radiation tissue injury (LRTI). Hyperbaric oxygen therapy (HBOT) involves breathing oxygen in a specially designed chamber. It is used as a treatment to improve oxygen supply to damaged tissue and stimulate healing. We found some evidence that LRTI affecting the head, neck and lower end of the bowel can be improved with HBOT. There is little evidence for or against benefit in other tissues affected by LRTI. Our conclusions are based on eight randomised trials with a limited number of patients. Further research is needed.

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Available from: Michael Bennett, Oct 04, 2015
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    • "HBO 2 treatment involves breathing 100% O 2 at 2 to 3 atmospheres absolute (ATA) pressure for 1.5 to 2 h once or twice daily. HBO 2 has been shown to improve refractory diabetic wounds and delayed radiation injuries in randomized trials and use is supported by independent evidencebased reviews (Bennett et al., 2008; Clarke et al., 2008; Kranke et al., 2012; Goldman, 2009; Fife et al., 2007; Duzgun et al., 2008; Londahl et al., 2010). Several studies have failed to identify clinical efficacy (Annane et al., 2004; Margolis et al., 2013). "
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    ABSTRACT: Because hyperbaric oxygen treatment mobilizes bone marrow derived-stem/progenitor cells by a free radical mediated mechanism, we hypothesized that there may be differences in mobilization efficiency based on exposure to different oxygen partial pressures. Blood from twenty consecutive patients was obtained before and after the 1st, 10th and 20th treatment at two clinical centers using protocols involving exposures to oxygen at either 2.0 or 2.5 atmospheres absolute (ATA). Post-treatment values of CD34+, CD45-dim leukocytes were always 2-fold greater than the pre-treatment values for both protocols. Values for those treated at 2.5 ATA were significantly greater than those treated at 2.0 ATA by factors of 1.9 to 3-fold after the 10th and before and after the 20th treatments. Intracellular content of hypoxia inducible factors -1, -2, and -3, thioredoxin-1 and poly-ADP-ribose polymerase assessed in permeabilized CD34+ cells with fluorophore-conjugated antibodies were twice as high in all post- versus pre-treatment samples with no significant differences between 2.0 and 2.5 ATA protocols. We conclude that putative progenitor cell mobilization is higher with 2.5 versus 2.0 ATA treatments, and all newly mobilized cells exhibit higher concentrations of an array of regulatory proteins.
    Stem Cell Research 02/2014; 12(3):638-645. DOI:10.1016/j.scr.2014.02.005 · 3.69 Impact Factor
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    • "Gastroenterology Research and Practice with PRD who were resistant to conventional oral or topical treatments [6] "
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    ABSTRACT: Pelvic radiation disease (PRD) occurs in 2-11% of patients undergoing pelvic radiation for urologic and gynecologic malignancies. Hyperbaric oxygen therapy (HBOT) has previously been described as a noninvasive therapeutic option for the treatment of PRD. the purpose of study was to analyze prospectively the results of HBOT in 44 consecutive patients with PRD who were resistant to conventional oral or topical treatments. Material and Methods. The median age of the cohort was 65.7 years (39-85). Twenty-seven percent of patients required blood transfusion (n = 12). The median of delay between radiotherapy and HBOT was 26 months (3-175). We evaluated the results of HBOT, using SOMA-LENT Scale. Results. SOMA-LENT score was decreased in 59% of patient. The median of SOMA-LENT score before HBOT was significantly higher, being equal to 14 (0-36), than after HBOT with the SOMA-LENT score of 12 (0-38) (P = 0.003). Tenesmus (P = 0.02), bleeding (P = 0.0001), and ulceration (P = 0.001) significantly decreased after HBOT. Regarding patients with colostomy, 33% (n = 4) benefited from colostomies closure. HBOT was generally well tolerated. Only one patient stopped precociously due to transient myopia. Conclusion. This study is in favor of the interest of HBOT in pelvic radiation disease treatment (PRD).
    Gastroenterology Research and Practice 01/2014; 2014(2):108073. DOI:10.1155/2014/108073 · 1.75 Impact Factor
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    • "The rationale for using HBO is that the intermittent elevation of tissue oxygen tension stimulates collagen synthesis and fibroblastic proliferation, promotes the growth of new capillaries, and enhances the phagocytic ability of leukocytes [3]. However, some controversy of its efficacy , lack of availability, and high price are potential disadvantages [4] [5] [6]. "
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    ABSTRACT: Osteoradionecrosis of jaws (ORNJ) is a serious complication of radiotherapy for patients with head and neck cancer. As of yet, no universally accepted treatment exists for this chronic pathologic condition. It has been shown that ultrasound is an effective, noninvasive adjunctive therapy in ORNJ, as ultrasound can result in the increase of angiogenesis and bone production, which are essential for ORNJ healing. Recently, low-frequency ultrasound has been demonstrated to enhance the transdermal delivery of macromolecules and hydrophilic drugs (low-frequency sonophoresis, LFS). As a biological macromolecule, basic fibroblast growth factor (bFGF) also has potential osteoinductive and angiogenic properties. Herein, we present a hypothesis that LFS-mediated transdermal bFGF delivery is capable of improving the healing of ORNJ and will be a new effective adjunctive therapy to surgery. This treatment combines low-frequency ultrasound with bFGF to respectively promote vascularly compromised bone and soft tissue wound healing, and is expected to be more effective than ultrasound therapy alone.
    Iranian Journal of Medical Hypotheses and Ideas 01/2014; 9(1). DOI:10.1016/j.jmhi.2014.07.001
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