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Hyperbaric oxygen therapy for late radiation tissue injury
M H Bennett1, J Feldmeier, N Hampson
1Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, Barker Street, Randwick, New South Wales, Australia, 2031. m.bennett@unsw.edu.au
The Cochrane Database of Systematic Reviews
|July 22, 2005
Summary
Hyperbaric oxygen therapy (HBOT) shows promise for healing late radiation-induced tissue injury (LRTI) in head, neck, and rectal areas. While effective for certain conditions like radiation proctitis and surgical flaps, its benefits for neural tissue remain unproven.
Area of Science:
- Oncology
- Radiotherapy
- Hyperbaric Medicine
Background:
- Cancer radiotherapy survivors may develop late radiation-induced tissue injury (LRTI) months or years post-treatment.
- Hyperbaric oxygen therapy (HBOT) is proposed to treat LRTI by improving tissue blood supply and promoting healing.
- HBOT may also prevent complications following surgical procedures in irradiated areas.
Purpose of the Study:
- To evaluate the efficacy and safety of HBOT for treating and preventing LRTI.
- To assess the benefits and harms associated with HBOT in managing radiation-induced complications.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches (CENTRAL, MEDLINE, EMBASE, CINAHL, DORCTHIM) up to September 2004.
- Inclusion criteria focused on RCTs comparing HBOT with no HBOT for LRTI prevention or healing.
- Data extraction and quality assessment were performed independently by three reviewers following Cochrane Handbook guidelines.
Main Results:
- Six RCTs involving 447 participants were included.
- Significant improvements in healing were observed with HBOT for radiation proctitis (RR 2.7), surgical flaps (RR 8.7), hemimandibulectomy reconstruction (RR 1.4), and irradiated tooth sockets post-extraction (RR 1.4).
- No significant benefit was found for established radiation injury to neural tissue; adverse effects were not reported in the included trials.
Conclusions:
- HBOT appears beneficial for LRTI affecting tissues of the head, neck, anus, and rectum, and for preventing osteoradionecrosis after tooth extraction in irradiated fields.
- Evidence for HBOT's efficacy in neurological tissues is lacking.
- Further research is needed to optimize patient selection and treatment timing, alongside economic evaluations.