Hyperbaric oxygen therapy for late radiation tissue injury

Area of Science:

• Oncology
• Radiotherapy
• Hyperbaric Medicine

Background:

• Radiotherapy, a common cancer treatment, can lead to late radiation tissue injury (LRTI) months or years post-treatment.
• Hyperbaric oxygen therapy (HBOT) is explored for LRTI due to its potential to enhance tissue blood supply and promote healing.
• HBOT may also play a role in preventing complications following surgery in irradiated areas.

Purpose of the Study:

• To systematically evaluate the efficacy and safety of hyperbaric oxygen therapy (HBOT) for the treatment and prevention of late radiation tissue injury (LRTI).

Main Methods:

• A systematic review of randomized controlled trials (RCTs) was conducted, searching multiple databases including CENTRAL, MEDLINE, and EMBASE up to March 2011.
• Eleven RCTs involving 669 participants were included, with data independently extracted and trial quality assessed.
• The review focused on comparing HBOT versus no HBOT for LRTI prevention or healing.

Main Results:

• HBOT demonstrated a significant benefit in achieving mucosal coverage for osteoradionecrosis (ORN), with a NNTB of 5.
• Improved outcomes were observed for radiation proctitis, surgical flaps, and hemimandibulectomy in patients receiving HBOT.
• HBOT also significantly improved the healing of irradiated tooth sockets following dental extraction (NNTB 4), but showed no benefit for neural tissue injury.

Conclusions:

• Small trials suggest HBOT is associated with improved outcomes for LRTI affecting head, neck, anus, and rectal tissues.
• HBOT may reduce the incidence of ORN after tooth extraction in irradiated fields.
• Further research is needed to optimize patient selection and treatment timing, and an economic evaluation is recommended.