Hyperbaric oxygen therapy for radiation enteritis and clinical parameters: a systematic review and meta-analysis
Yuhan Wang1, Xuhui Yang1, Minjiao Jiang2
1Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Background:
Hyperbaric oxygen therapy (HBOT) has been debated regarding its efficacy and safety in treating radiation enteritis (RE), with no standardized clinical protocols established. This study evaluates the clinical evidence on the use of HBOT in the management of RE, focusing on efficacy, safety, treatment parameters, and potential mechanisms.
Methods:
A comprehensive computer-based search was conducted across nine databases. The study assessed the effects of HBOT on gastrointestinal symptoms, immune function, inflammation, and its role in reducing the incidence of moderate to severe RE. Additionally, clinical application protocols were analyzed.
Results:
This study analyzed data from 22 clinical studies involving 1,318 subjects, including six RCTs incorporated into a meta-analysis. Moderate-quality evidence suggested that HBOT could significantly reduce the incidence of RE [OR = 0.32, 95% CI (0.14, 0.72), P = 0.006], particularly showing a significant advantage in decreasing the incidence of grade 3 or higher RE according to the RTOG/EORTC criteria [OR = 0.37, 95% CI (0.17, 0.82), P = 0.01]. Additionally, HBOT was shown to effectively improve gastrointestinal symptoms [MD = -1.31, 95% CI (-2.48, -0.13), P = 0.03]. Low-quality evidence suggested that HBOT reduced inflammatory markers (IL-6, CRP, TNF-α) and increased immunoglobulin levels (IgA, IgG, IgM). The most commonly reported protocol parameters were 2.0-2.5 ATA, 90-120 min per session, once daily, five times per week, for 30-40 sessions.
Conclusion:
This study demonstrates that HBOT effectively alleviates gastrointestinal symptoms, promotes mucosal repair, reduces inflammation, and enhances immune function in patients with RE. HBOT significantly decreases the incidence of RE, particularly severe enteritis. Optimized treatment protocols and individualized adjustments are essential for achieving optimal outcomes. Despite the potential benefits of HBOT for RE, caution is still warranted in clinical practice, with optimization of treatment protocols and individualized adjustments to ensure optimal efficacy.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/, CRD42024618971.
Related Concept Videos
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...