HBOT for late sequelae in women receiving radiation after breast-conserving surgery
Auteur(s)
Ulrich M. Carl, M.D, John J. Feldmeier, D.O., Gerd Schmitt, M.D., K. Axel Hartmann, M.D.
Jaartal
2001
Tijdschrift
Int. J. Radiation Oncology Biol. Phys., Vol. 49, No. 4, pp. 1029–1031
Type publicatie
Onderzoek
Onderzoek
Patient controle prospectief gerandomiseerd
Aantal
44 (32 patient, 12 controle)
Selectiecriteria
All patients with pain higher than Grade III or with a total score of at least 8 points
Methode
From July 1996 to March 1999, 635 patients in the Clinic for Radiation Oncology, University Duesseldorf were followed after breast-conserving therapy.
In the case of late radiation effects, sequelae were recorded according to modified LENT-SOMA criteria (9, Table 1).
All patients with pain higher than Grade III or with a total score of at least 8 points were candidates for hyperbaric oxygen therapy. Thus, a total of 44 patients with symptomatic breast edema fulfilling the inclusion criteria were identified. Thirty-two patients were enrolled in a treatment protocol with hyperbaric oxygen therapy. Twelve women received no further treatment and served as controls, because they refused to undergo hyperbaric oxygen therapy
In the case of late radiation effects, sequelae were recorded according to modified LENT-SOMA criteria (9, Table 1).
All patients with pain higher than Grade III or with a total score of at least 8 points were candidates for hyperbaric oxygen therapy. Thus, a total of 44 patients with symptomatic breast edema fulfilling the inclusion criteria were identified. Thirty-two patients were enrolled in a treatment protocol with hyperbaric oxygen therapy. Twelve women received no further treatment and served as controls, because they refused to undergo hyperbaric oxygen therapy
Resultaat
Pre- and posttreatment scores for observation and hyperbaric oxygen therapy groups are summarized. (see table 2 in article)
The comparison of pre-treatment scores for both groups revealed no significant differences. Group assignment was not randomized, and it is possible though not obvious that a bias in selection or symptom grading was experienced.
Patients treated with hyperbaric oxygen showed a significant reduction of pain, edema, and erythema scores compared to untreated controls ( p , 0.001). Fibrosis and telangiectasia were not significantly affected by hyperbaric oxygen therapy. Seven of 32 patients were completely free of symptoms after hyperbaric oxygen therapy, whereas all 12 patients reported persisting complains after observation alone. No toxicities related to hyperbaric oxygen therapy were observed.
The comparison of pre-treatment scores for both groups revealed no significant differences. Group assignment was not randomized, and it is possible though not obvious that a bias in selection or symptom grading was experienced.
Patients treated with hyperbaric oxygen showed a significant reduction of pain, edema, and erythema scores compared to untreated controls ( p , 0.001). Fibrosis and telangiectasia were not significantly affected by hyperbaric oxygen therapy. Seven of 32 patients were completely free of symptoms after hyperbaric oxygen therapy, whereas all 12 patients reported persisting complains after observation alone. No toxicities related to hyperbaric oxygen therapy were observed.
Conclusie
From this study, it is concluded that hyperbaric oxygen is a valuable clinical tool for patients suffering from persisting pain, edema, and erythema following breast irradiation. A prospective randomized trial to test the efficacy of hyperbaric oxygenation is in preparation.
Externe link
Indicatie
LRTI mamma
