Hyperbaric Oxygen Therapy for Management of Late Radiation Toxicity—A Honey of a Trial?
Mené sur 186 patientes atteintes d'un cancer du sein traité par radiothérapie adjuvante, cet essai randomisé évalue l'efficacité, du point de vue de la réduction des effets indésirables localisés induits par les rayonnements (douleurs, oedème, fibrose, restriction de mouvement), d'une oxygénothérapie hyperbare
Hyperbaric oxygen therapy (HBOT) represents a modality of interest to many oncologists, even if not well understood and seldom used by many in practice. To the radiation oncologist in particular, and to patients who experience late toxicities of radiotherapy such as fibrosis and pain, HBOT offers an ember of hope in the desperate attempt to treat these chronic adverse effects of therapy. The US Food and Drug Administration has cleared HBOT for marketing in the framework of regulated medical devices for several conditions, such as nonhealing wounds, decompression sickness, and radiation injury. Work is also ongoing to determine efficacy of HBOT in diverse scenarios ranging from a priori radiation sensitization to chronic fatigue syndrome and from early use to use only in desperate situations. However, the agency cautions clinicians to be wary of unproven claims of effect, perhaps highlighting the vulnerability of patients seeking therapy for some of the most troubling ailments. Moreover, there is concern that the burgeoning industry of HBOT might include unscrupulous centers since only 154 facilities in the United States, out of well over 1000, are accredited by the Undersea and Hyperbaric Medical Society, and findings of misuse have been previously documented.