Center for Hyperbaric Medicine, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101, USA.
Cancer. 2012 Aug 1;118(15):3860-8. doi: 10.1002/cncr.26637. Epub 2011 Dec 2.
Although hyperbaric oxygen is used to treat chronic radiation tissue injury, clinical evidence supporting its efficacy has been limited to date. The authors report prospectively collected patient outcomes from a single center's large experience using hyperbaric oxygen to treat chronic radiation injury.
Since 2002, patient outcomes at the conclusion of a course of hyperbaric oxygen treatment for chronic radiation tissue injury at Virginia Mason Medical Center in Seattle have been graded by a board-certified hyperbaric physician and prospectively recorded. From 2002 to 2010, a total of 525 patients received treatment for 1 of 6 forms of radionecrosis analyzed. After excluding 114 patients for incomplete records or treatment courses or for previous receipt of hyperbaric oxygen therapy, records of 411 patients were retrospectively reviewed in 2010, and outcomes were regraded by a second board-certified physician. A positive clinical response was defined as an outcome graded as either "resolved" (90%-100% improved) or "significantly improved" (50%-89% improved).
A positive outcome from hyperbaric treatment occurred in 94% of patients with osteoradionecrosis of the jaw (n = 43), 76% of patients with cutaneous radionecrosis that caused open wounds (n = 58), 82% of patients with laryngeal radionecrosis (n = 27), 89% of patients with radiation cystitis (n = 44), 63% of patients with gastrointestinal radionecrosis (n = 73), and 100% of patients who were treated in conjunction with oral surgery in a previously irradiated jaw (n = 166).
The outcomes of 411 patients collected prospectively over 8 years strongly supported the efficacy of hyperbaric oxygen treatment for the 6 conditions evaluated. The response rates previously reported in numerous small series were supported by the responses achieved in this large, single-center experience.
尽管高压氧被用于治疗慢性放射性组织损伤，但迄今为止，支持其疗效的临床证据有限。作者报告了来自西雅图弗吉尼亚梅森医疗中心单一中心大量使用高压氧治疗慢性放射性损伤患者的前瞻性收集的结果。
自 2002 年以来，弗吉尼亚梅森医疗中心的一名经过委员会认证的高压氧医师对每位接受高压氧治疗慢性放射性组织损伤的患者进行治疗结束时的结局分级，并进行前瞻性记录。2002 年至 2010 年，共有 525 例患者因 6 种放射性坏死中的 1 种接受治疗。排除 114 例记录不完整或治疗过程不完整或之前接受过高压氧治疗的患者后，2010 年回顾性分析了 411 例患者的记录，并由第二位经过委员会认证的医师重新分级。阳性临床反应定义为结局分级为“完全缓解”（改善 90%-100%）或“明显缓解”（改善 50%-89%）的患者。
颌骨放射性骨坏死（n = 43）、引起开放性伤口的皮肤放射性坏死（n = 58）、喉放射性坏死（n = 27）、放射性膀胱炎（n = 44）、胃肠道放射性坏死（n = 73）患者中，高压氧治疗的阳性结局分别发生在 94%、76%、82%、89%、63%和 100%的患者中，在之前接受过放疗的颌骨中与口腔手术联合治疗的 166 例患者中，阳性结局发生率为 100%。
8 年期间前瞻性收集的 411 例患者的结果强烈支持高压氧治疗 6 种评估疾病的疗效。大量单一中心经验中获得的反应支持了以前在许多小系列中报道的反应率。
