Sensitizing brain metastases to stereotactic radiosurgery using hyperbaric oxygen: A proof-of-principle study.

Area of Science:

• Oncology
• Radiation Oncology
• Neurosurgery

Background:

• Brain metastases pose a significant challenge in cancer treatment.
• Stereotactic radiosurgery (SRS) is a primary treatment modality for brain metastases.
• Increasing oxygen levels may enhance the efficacy of radiation therapy.

Purpose of the Study:

• To assess the feasibility and safety of administering hyperbaric oxygen (HBO) before SRS for brain metastases.
• To evaluate the impact of HBO combined with SRS on treatment response and clinical outcomes.
• To determine if HBO enhances radiosensitivity without increasing adverse events.

Main Methods:

• A prospective study involving 38 patients with brain metastases.
• 19 patients received HBO prior to SRS, compared to 19 matched historical controls.
• Outcomes measured included time from HBO to SRS, quality of life, local control, distant recurrence, radionecrosis, and overall survival.

Main Results:

• The average time from HBO to SRS was 8.3 minutes.
• Adverse events were comparable between the HBO and control groups, with no grade III or IV serious events observed.
• While not statistically significant, 1-year survival rates trended higher for the SRS + HBO group across multiple endpoints, including local control and overall survival. No significant association was found between HBO and increased risk of recurrence or mortality.

Conclusions:

• Combining hyperbaric oxygen with stereotactic radiosurgery for brain metastases is feasible.
• This combined approach does not appear to increase the risk of radiation necrosis or negatively impact other clinical outcomes.
• The addition of HBO to SRS shows a trend towards improved survival outcomes for patients with brain metastases.