[Hyperbaric oxygen and radiotherapy: From myth to reality]

Area of Science:

• Oncology
• Radiotherapy
• Hyperbaric Medicine

Background:

• Radiotherapy is a common cancer treatment, with over a million patients annually receiving curative doses.
• Despite improved outcomes, 5-15% of patients experience severe late toxicities post-radiotherapy.
• Treating these late toxicities is challenging, prompting investigation into novel therapeutic approaches.

Purpose of the Study:

• To review the established and debated indications for hyperbaric oxygen therapy (HBOT) in managing radiation-induced late toxicities.
• To assess the current knowledge and practices of French radiation therapists regarding HBOT for these conditions.

Main Methods:

• A comprehensive literature review was conducted to identify studies on HBOT for radiation-induced late toxicities.
• A survey was used to evaluate the knowledge and practice patterns of French radiation therapists concerning HBOT.

Main Results:

• HBOT shows promise as a conservative treatment for hemorrhagic cystitis and radiation-induced pain, particularly after failure of drug therapies, potentially avoiding surgery.
• HBOT may reduce complications associated with tooth extraction in irradiated tissues.
• Evidence for HBOT's efficacy in conditions like mandibular osteoradionecrosis, radiation proctitis/enteritis, lymphoedema, brachial plexopathy, and neurological sequelae is conflicting.

Conclusions:

• Hyperbaric oxygen therapy can be a valuable conservative option for specific radiation-induced toxicities, such as hemorrhagic cystitis and pain.
• The role of HBOT in other radiation-induced complications remains uncertain, necessitating further investigation.
• Results from ongoing phase III studies are anticipated to provide clearer guidance on HBOT's utility in managing a broader range of radio-induced toxicities, including head and neck complications.