Hyperbaric oxygenation for tumour sensitisation to radiotherapy

Area of Science:

• Oncology
• Radiotherapy
• Hyperbaric Medicine

Background:

• Radiotherapy is a standard treatment for solid tumors.
• Hypoxic cancer cells pose a challenge to radiotherapy efficacy.
• Hyperbaric oxygenation therapy (HBOT) may enhance radiotherapy by targeting hypoxic cells.

Purpose of the Study:

• To evaluate the benefits and harms of combining radiotherapy with hyperbaric oxygen (HBO).
• To assess the impact of HBOT on cancer treatment outcomes and adverse events.

Main Methods:

• Systematic review of randomized and quasi-randomized controlled trials.
• Searched multiple databases including CENTRAL, MEDLINE, and Embase.
• Included 19 trials with 2286 participants comparing HBOT with control groups.

Main Results:

• For head and neck cancer, HBOT improved survival and local tumor control, with reduced recurrence rates.
• HBOT increased the risk of severe radiation reactions but did not significantly increase seizure risk.
• For cervical and bladder cancers, HBOT showed no clear benefits in mortality or recurrence, but increased adverse effects.

Conclusions:

• HBOT demonstrates potential benefits for head and neck cancers, particularly with specific fractionation schedules.
• Significant increase in severe radiation injury is associated with HBOT.
• Further research is warranted for head and neck cancers; less so for cervical and bladder cancers due to lack of demonstrated benefit.