在希望和不确定性之间:高压氧气疗法和放射治疗的难以捉摸的证据
Francesco Cuccia1, Andrea Neville Cracchiolo2, Antonio Piras3
1Radiation Oncology, ARNAS Civico Hospital - Palermo, Palermo, Italy. francesco.cuccia@arnascivico.it.
概括
高压氧气疗法 (HBOT) 显示出对管理晚期辐射组织损伤,特别是盆腔毒性的承诺. 然而,它的有效性因癌症部位而异,需要更多的研究来确认它的好处和最佳使用.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 高压医学的高压医学.
背景情况:
- 晚期辐射组织损伤 (LRTI) 影响约5%的癌症患者进行放射治疗后 (RT),影响生活质量.
- 高压氧气疗法 (HBOT) 正在探索RT诱导的毒性和作为放射敏感剂,但证据有限.
研究的目的:
- 在接受放射治疗 (RT) 的患者中,系统地审查高压氧疗 (HBOT) 的疗效和安全性.
- 评估HBOT在管理晚期辐射组织损伤 (LRTI) 和其潜在的放射敏感性影响中的作用.
主要方法:
- 对PubMed,Embase和Cochrane数据库 (2000-2025) 的系统审查.
- 包括评估RT患者HBOT的研究;不包括评论和小型病例报告.
- 提取的数据包括研究设计,患者/治疗细节,HBOT参数,结果和毒性.
主要成果:
- 分析了42项研究 (2785名患者);28项追溯研究,5项RCT.
- 对于像出血性囊炎这样的盆腔毒性,HBOT显示出高响应率 (67-100%).
- 乳腺/头癌的益处在不同类型的研究中不一致;安全性概况一般好.
结论:
- 在缓解晚期RT毒性方面,HBOT是有希望的,尤其是盆腔毒性.
- 其他地点的证据是相互矛盾的,它的放射敏感作用是推测性的.
- 精心设计的前性试验对于在RT患者中定义最佳的HBOT使用至关重要.
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