Pasquier David, Hoelscher Tobias, Schmutz Jorg, Dische Stanley, Mathieu Daniel, Baumann Michael, Lartigau Eric
Department of Radiotherapy, Centre Oscar Lambret, 59020 Lille, France.
Radiother Oncol. 2004 Jul;72(1):1-13. doi: 10.1016/j.radonc.2004.04.005.
Late complications are one of the major factors limiting radiotherapy treatment, and their treatment is not codified. Hyperbaric oxygen (HBO) has been used in combination with radiotherapy for over half a century, either to maximise its effectiveness or in an attempt to treat late complications. In this latter case, retrospective trials and case reports are prevailing in literature. This prompted European Society for Therapeutic Radiotherapy and Oncology and European Committee for Hyperbaric Medicine to organise a consensus conference in October 2001, dealing with the HBO indications on radiotherapy for the treatment and prevention of late complications. This updated literature review is part of the documents the jury based its opinion on. A systematic search was done on literature from 1960 to 2004, by only taking into account the articles that appeared in peer review journals. Hyperbaric oxygen treatment involving complications to the head and neck, pelvis and nervous system, and the prevention of complications after surgery in irradiated tissues have been studied. Despite the small number of controlled trials, it may be indicated for the treatment of mandibular osteoradionecrosis in combination with surgery, haemorrhagic cystitis resistant to conventional treatments and the prevention of osteoradionecrosis after dental extraction, whose level of evidence seems to be the most significant though randomised trials are still necessary. The other treatment methods are also outlined for each location.
晚期并发症是限制放射治疗的主要因素之一,且其治疗方法尚无统一规范。半个多世纪以来,高压氧(HBO)一直与放射治疗联合使用,要么是为了最大化放疗效果,要么是试图治疗晚期并发症。在后一种情况下,文献中主要是回顾性试验和病例报告。这促使欧洲放射治疗与肿瘤学会以及欧洲高压医学委员会于2001年10月组织了一次共识会议,讨论HBO在放射治疗中治疗和预防晚期并发症的适应症。这篇更新的文献综述是专家评审团形成意见所依据的文件的一部分。通过仅考虑发表在同行评审期刊上的文章,对1960年至2004年的文献进行了系统检索。研究了涉及头颈部、骨盆和神经系统并发症的高压氧治疗,以及放疗组织术后并发症的预防。尽管对照试验数量较少,但高压氧治疗可能适用于联合手术治疗下颌骨放射性骨坏死、治疗对传统治疗耐药的出血性膀胱炎以及预防拔牙后放射性骨坏死,尽管仍需要随机试验,但现有证据水平似乎最为显著。文中还概述了针对每个部位的其他治疗方法。