Hyperbaric Oxygen and Radiotherapy

Mayer, Ramona; Hamilton-Farrell, M R; Kleij, A. J. van der; Schmutz, Jörg; Granström, Gösta; Sićko, Zdzisław; Melamed, Yuval; Carl, U. M.; Hartmann, Karl; Jansen, Erik C.; Ditri, Luciano; Sminia, Peter

doi:10.1007/s00066-005-1277-y

Cited by 98 publications

(77 citation statements)

References 48 publications

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“…In recent years, radiotherapy immediately after HBO has been emerging as an attractive approach for overcoming hypoxia in cancer treatment (Al-Waili et al, 2005;Bennett et al, 2005;Mayer et al, 2005). Several experimental studies have indicated that the elevation in oxygen tension in the tumour is preserved for some time following HBO treatment, thereby allowing the administration of radiotherapy with an improved tumour/normal tissue oxygenation ratio (Kinoshita et al, 2000;Kunugita et al, 2001;Beppu et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Phase II trial of radiotherapy after hyperbaric oxygenation with chemotherapy for high-grade gliomas

et al. 2006

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We conducted a phase II trial to evaluate the efficacy and toxicity of radiotherapy immediately after hyperbaric oxygenation (HBO) with chemotherapy in adults with high-grade gliomas. Patients with histologically confirmed high-grade gliomas were administered radiotherapy in daily 2 Gy fractions for 5 consecutive days per week up to a total dose of 60 Gy. Each fraction was administered immediately after HBO with the period of time from completion of decompression to irradiation being less than 15 min. Chemotherapy consisted of procarbazine, nimustine (ACNU) and vincristine and was administered during and after radiotherapy. A total of 41 patients (31 patients with glioblastoma and 10 patients with grade 3 gliomas) were enrolled. All 41 patients were able to complete a total radiotherapy dose of 60 Gy immediately after HBO with one course of concurrent chemotherapy. Of 30 assessable patients, 17 (57%) had an objective response including four CR and 13 PR. The median time to progression and the median survival time in glioblastoma patients were 12.3 months and 17.3 months, respectively. On univariate analysis, histologic grade (P ¼ 0.0001) and Karnofsky performance status (P ¼ 0.036) had a significant impact on survival, and on multivariate analysis, histologic grade alone was a significant prognostic factor for survival (P ¼ 0.001). Although grade 4 leukopenia and grade 4 thrombocytopenia occurred in 10 and 7% of all patients, respectively, these were transient with no patients developing neutropenic fever or intracranial haemorrhage. No serious nonhaematological or late toxicities were seen. These results indicated that radiotherapy delivered immediately after HBO with chemotherapy was safe with virtually no late toxicity in patients with high-grade gliomas. Further studies are required to strictly evaluate the effectiveness of radiotherapy after HBO for these tumours.

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Section: Discussionmentioning

confidence: 99%

Phase II trial of radiotherapy after hyperbaric oxygenation with chemotherapy for high-grade gliomas

et al. 2006

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“…Moreover, clinical studies in patients with gliomas 160 and NSCLC (ref. 161 ) have shown promising results, and several studies with the combination of HBOT and radiotherapy have been also performed 162 . However, this approach is still in its infancy and a number of questions, e.g.…”

Section: Future Perspectivesmentioning

confidence: 99%

Hypoxia-induced chemoresistance in cancer cells: The role of not only HIF-1

Doktorova

Hraběta

Khalil

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. The aim of this review is to provide the information about molecular basis of hypoxia-induced chemoresistance, focusing on the possibility of diagnostic and therapeutic use. Results. Hypoxia is a common feature of tumors and represents an independent prognostic factor in many cancers. It is the result of imbalances in the intake and consumption of oxygen caused by abnormal vessels in the tumor and the rapid proliferation of cancer cells. Hypoxia-induced resistance to cisplatin, doxorubicin, etoposide, melphalan, 5-flouoruracil, gemcitabine, and docetaxel has been reported in a number of experiments. Adaptation of tumor cells to hypoxia has important biological effects. The most studied factor responsible for these effects is hypoxia-inducible factor-1 (HIF-1) that significantly contributes to the aggressiveness and chemoresistance of different tumors. The HIF-1 complex, induced by hypoxia, binds to target genes, thereby increasing the expression of many genes. In addition, the expression of hundreds of genes can be also decreased in response to hypoxia in HIF-1 dependent manner, but without the detection of HIF-1 in these genes' promoters. HIF-1 independent mechanisms for drug resistance in hypoxia have been described, however, they are still rarely reported. The first clinical studies focusing on diagnosis of hypoxia and on inhibition of hypoxia-induced changes in cancer cells are starting to yield results. Conclusions. The adaptation to hypoxia requires many genetic and biochemical responses that regulate one another. Hypoxia-induced resistance is a very complex field and we still know very little about it. Different approaches to circumvent hypoxia in tumors are under development.

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“…Systematic reviews of HBOT and cancer have described the use of HBOT in patients with malignancy (Daruwalla and Christophi, 2006;Hoggan and Cameron, 2014;Mayer et al, 2005;Moen and Stuhr, 2012). However, several unsolved questions remain connected with HBOT treatment, including severe DNA damage and genetic instability leading to reactivation or augmentation of existing cancer, development of fragile and porous capillaries and associated higher chance of metastasis, initiating aneuplody causing delay in DNA repair of surrounding normal or stromal cells.…”

Section: Abstract: Angiogenesis Chorioallantoic Membrane Hyperbarimentioning

confidence: 99%

Angiogenesis and hyperbaric oxygen in the chick embryo chorioallantoic membrane

et al. 2015

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Hyperbaric Oxygen Therapy (HBOT) is increasingly applied in different areas of medical practice. The oxy-hyperbarism effects are not well understood in cancer malignancy. One unique feature of cancer is the presence of hypoxic regions that are insensitive to conventional therapies. It is possible to alter the hypoxic state and produce reactive oxygen species for better treatment outcome by HBOT. In the present study, we determined the effects of HBOT on angiogenesis, a signature of cancer progression, by using the chick chorioallantoic membrane (CAM) in vivo assy. CAMs were exposed to 2.0 ATA (atmospheres absolute) for 30 min of hyperbaric oxygen on the 6 th and 7 th days of incubation (ED6, ED7). On the 10-11 th day of incubation, CAMs were excised from eggs, fixed and analysed using APERIO ImageScope software. HBOT outcomes were evaluated quantifying the volumetric area occupied by blood vessels and calculating the number of blood vessel ramifications. Results indicated that CAMs treated at ED6 and ED7 had a significantly higher CAM vascularization and an increased number of blood vessel ramifications (+82% higher for ED6) compared to untreated CAMs (ED6=63.3±2.5 and ED7=57.7±5.5 vs. CTRL=34.7±2.5). Thus, HBOT induces an angiogenic response in treated CAMs through a classic sprouting mechanism.

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Hyperbaric Oxygen and Radiotherapy

Abstract: Recruitment of centers and patients is being strongly encouraged, detailed information is given on www.oxynet.org.

Cited by 98 publications

References 48 publications

Phase II trial of radiotherapy after hyperbaric oxygenation with chemotherapy for high-grade gliomas

Phase II trial of radiotherapy after hyperbaric oxygenation with chemotherapy for high-grade gliomas

Hypoxia-induced chemoresistance in cancer cells: The role of not only HIF-1

Angiogenesis and hyperbaric oxygen in the chick embryo chorioallantoic membrane

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