Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues: a literature review

Pasquier, David; Hoelscher, T.; Schmutz, Jörg; Dische, Stanley; Mathieu, Daniel; Baumann, Michaël; Lartigau, Éric

doi:10.1016/j.radonc.2004.04.005

Cited by 111 publications

(60 citation statements)

References 170 publications

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“…Hypoxia is a potent inducer of HIF-1α which in turn releases other cytokines and intracellular adhesion molecule-1, which potentiate BBB breakdown [44]. By increasing tissue oxygenation, HBO may inhibit HIF-1α induction and release, preventing the subsequent cascade and release of factors responsible for propagating the cycle of RN.…”

Section: Discussionmentioning

confidence: 99%

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Laser Interstitial Thermal Therapy for Focal Cerebral Radiation Necrosis: A Case Report and Literature Review

Rahmathulla

Recinos

Valerio

et al. 2012

Stereotact Funct Neurosurg

150

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Whole-brain radiotherapy and stereotactic radiosurgery (SRS) play a central role in the treatment of metastatic brain tumors. Radiation necrosis occurs in 5% of patients and can be very difficult to treat. The available treatment options for radiation necrosis include prolonged high-dose corticosteroids, hyperbaric oxygen, anticoagulation, bevacizumab, and surgical resection. We present the first report and results using laser-interstitial thermal therapy (LITT) for medically refractory radionecrosis. A 74-year-old diabetic patient who had a history of non-small cell lung cancer with brain metastases and subsequent treatment with SRS, presented with a focal lesion in the left centrum semiovale with progressively worsening edema. Image findings were consistent with radiation necrosis that was refractory despite prolonged, high-dose steroid therapy. His associated comorbidities obviated alternative interventions and the lesion was not in a location amenable to surgical resection. We used laser thermal ablation to treat the biopsy-proven radionecrosis. The procedure was tolerated well and the patient was discharged 48 hours postoperatively. Imaging at 7-week follow-up showed near complete resolution of the edema and associated mass effect. Additionally, the patient was completely weaned off steroids. To our knowledge this is the first report using LITT for the treatment of focal radiation necrosis. LITT may be an effective treatment modality for patients with medically refractory radiation necrosis with lesions not amenable to surgical decompression.

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Section: Discussionmentioning

confidence: 99%

“…Various others have since reported their experience with the use of HBO in RN [5,46,47,48]. Because of the retrospective nature of data collection, and a majority of patients having received varying doses of concurrent steroids, evidence to support the use of HBO in radionecrosis remains weak [44]. …”

Section: Discussionmentioning

confidence: 99%

Laser Interstitial Thermal Therapy for Focal Cerebral Radiation Necrosis: A Case Report and Literature Review

Rahmathulla

Recinos

Valerio

et al. 2012

Stereotact Funct Neurosurg

150

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“…Potential mechanisms of action of HBOT include increased tissue oxygenation, reduction of oedema and capillary angiogenesis [12]. [13]. Guidelines were difficult to draw due to the limited documentation (including treatment course, exposure time and atmospheric pressure used).…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy for late radiation tissue injury in gynaecological patients

Rud

Bjørgo

Kristensen

et al. 2009

Support Care Cancer

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“…Hyperbaric oxygen therapy (HBOT) has been used to treat several medical conditions, including necrotising fasciitis and osteoradionecrosis [11]. It has been used in radiation oncology, as both a radiosensitiser and also as a treatment of late radiation effects.…”

Section: Discussionmentioning

confidence: 99%

“…In another retrospective trial of 75 patients with osteoradionecrosis, 81% of patients responded to HBOT [12]. The Consensus Conference, led by the European Society for Therapeutic Radiology and Oncology and the European Committee for Hyperbaric Medicine, recommended prospective collection of toxicity data and setting up of multi-centre randomized controlled trials to obtain higher levels of evidence for indications of HBOT [11].…”

Section: Discussionmentioning

confidence: 99%

A randomised prospective study of extended tocopherol and pentoxifylline therapy, in addition to carbogen, in the treatment of radiation late effects

Brennan¹,

Salib²,

O'Shea³

et al. 2008

ecancer

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Purpose: pentoxifylline (PTX) and tocopherol (vitamin E) are antioxidants previously shown to be useful in combination in the treatment of late radiation induced toxicity. The purpose of this study was to investigate the benefit of combination therapy with carbogen pentoxifylline and tocopherol in the mitigation of late radiation effects. As the optimal duration of PTX and tocopherol treatment has not been fully established, we studied short versus extended treatment duration.Methods: we conducted a phase II prospective randomized study of short versus prolonged treatment with pentoxifylline (800 mg) and tocopherol (1000 IU) orally once daily in patients with grade three toxicity post-radical radiotherapy. In addition, all 18 patients received inhaled carbogen (95% O + 5% CO 2 ) over 90 minutes, five days/week, for three weeks. The primary end point was improved in maximum Lent-Soma toxicity scores.Results: maximum Lent-Soma scores improved in six of the 18 patients (response rate 33%). The proportion of patients responding to treatment in the prolonged treatment arm B was more than double than in the shorter arm A, but this did not reach statistical significance (p=0.321). Two patients who had prolonged treatment (arm B) had complete resolution of their symptoms, which was maintained at two and three year follow-ups.Conclusions: we recommend prolonged treatment for 12 months, with PTX and tocopherol in combination with carbogen therapy, in the management of late radiation effects.

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Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues: a literature review

Cited by 111 publications

References 170 publications

Laser Interstitial Thermal Therapy for Focal Cerebral Radiation Necrosis: A Case Report and Literature Review

Laser Interstitial Thermal Therapy for Focal Cerebral Radiation Necrosis: A Case Report and Literature Review

Hyperbaric oxygen therapy for late radiation tissue injury in gynaecological patients

A randomised prospective study of extended tocopherol and pentoxifylline therapy, in addition to carbogen, in the treatment of radiation late effects

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