Hyperbaric oxygen therapy for late radiation tissue injury

Area of Science:

• Oncology
• Radiotherapy
• Hyperbaric Medicine

Background:

• Cancer radiotherapy survivors may develop 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 prevent post-surgical complications in irradiated tissues.

Purpose of the Study:

• To evaluate the efficacy and safety of HBOT in treating and preventing LRTI.
• To synthesize evidence from randomized controlled trials on HBOT for LRTI.

Main Methods:

• Systematic search of multiple databases including CENTRAL, MEDLINE, and EMBASE up to December 2015.
• Inclusion of randomized controlled trials (RCTs) comparing HBOT with no HBOT for LRTI prevention or healing.
• Independent quality assessment and data extraction by three review authors.

Main Results:

• Moderate evidence suggests HBOT improves mucosal coverage in osteoradionecrosis (ORN) and reduces wound breakdown post-ORN surgery.
• HBOT showed significant benefits for radiation proctitis, surgical flaps, hemimandibulectomy, and healing irradiated tooth sockets post-extraction.
• No significant benefits were observed for established radiation injury to neural tissues; adverse events were not reported.

Conclusions:

• HBOT appears beneficial for LRTI affecting head, neck, and anorectal tissues, and for preventing ORN post-extraction.
• Evidence for HBOT's effect on neurological tissues is lacking.
• Further research is needed to optimize patient selection and treatment timing, with economic evaluation recommended.