Mayer Ramona, Hamilton-Farrell Martin R, van der Kleij Adrian J, Schmutz Jörg, Granström Gösta, Sicko Zdzislaw, Melamed Yehuda, Carl Ulrich M, Hartmann K Axel, Jansen Erik C, Ditri Luciano, Sminia Peter
Department of Radiation Oncology, Medical University of Graz, Austria.
Strahlenther Onkol. 2005 Feb;181(2):113-23. doi: 10.1007/s00066-005-1277-y.
Hyperbaric oxygen (HBO) therapy is the inhalation of 100% oxygen at a pressure of at least 1.5 atmospheres absolute (150 kPa). It uses oxygen as a drug by dissolving it in the plasma and delivering it to the tissues independent of hemoglobin. For a variety of organ systems, HBO is known to promote new vessel growth into areas with reduced oxygen tension due to poor vascularity, and therewith promotes wound healing and recovery of radiation-injured tissue. Furthermore, tumors may be sensitized to irradiation by raising intratumoral oxygen tensions.
A network of hyperbaric facilities exists in Europe, and a number of clinical studies are ongoing. The intergovernmental framework COST B14 action "Hyperbaric Oxygen Therapy" started in 1999. The main goal of the Working Group Oncology is preparation and actual implementation of prospective study protocols in the field of HBO and radiation oncology in Europe.
In this paper a short overview on HBO is given and the following randomized clinical studies are presented: a) reirradiation of recurrent squamous cell carcinoma of the head and neck after HBO sensitization; b) role of HBO in enhancing radiosensitivity on glioblastoma multiforme; c) osseointegration in irradiated patients; adjunctive HBO to prevent implant failures; d) the role of HBO in the treatment of late irradiation sequelae in the pelvic region. The two radiosensitization protocols (a, b) allow a time interval between HBO and subsequent irradiation of 10-20 min.
Recruitment of centers and patients is being strongly encouraged, detailed information is given on www.oxynet.org.
高压氧(HBO)疗法是在至少1.5绝对大气压(150千帕)的压力下吸入100%的氧气。它通过将氧气溶解在血浆中并独立于血红蛋白将其输送到组织,从而将氧气用作一种药物。对于多种器官系统,已知HBO可促进新血管向因血管分布不良而氧张力降低的区域生长,进而促进伤口愈合和放射性损伤组织的恢复。此外,通过提高肿瘤内的氧张力,肿瘤可能对放疗更敏感。
欧洲存在一个高压氧设施网络,并且多项临床研究正在进行中。政府间框架COST B14行动“高压氧疗法”于1999年启动。肿瘤学工作组的主要目标是在欧洲准备并实际实施HBO与放射肿瘤学领域的前瞻性研究方案。
本文对HBO进行了简要概述,并介绍了以下随机临床研究:a)HBO增敏后对头颈部复发性鳞状细胞癌进行再照射;b)HBO对多形性胶质母细胞瘤放射增敏作用中的作用;c)放疗患者的骨整合;辅助HBO预防种植失败;d)HBO在治疗盆腔区域晚期放疗后遗症中的作用。两项放射增敏方案(a、b)允许HBO与后续放疗之间的时间间隔为10 - 20分钟。
强烈鼓励各中心和患者参与,详细信息可在www.oxynet.org上获取。