Chen Jun-rui, Xu Hong-zhi, Ding Jian-bo, Qin Zhi-yong
a Department of Neurosurgery , Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.
Curr Med Res Opin. 2015 Nov;31(11):1977-84. doi: 10.1185/03007995.2015.1082988. Epub 2015 Sep 28.
This review was to evaluate the efficacy and toxicity of radiation therapy (RT) administered immediately after hyperbaric oxygen (HBO) therapy in patients with high grade gliomas.
PubMed, Embase, ISI Web of Knowledge, and Cochrane databases were searched using combinations of the following search terms: radiotherapy, hyperbaric oxygenation, chemotherapy, glioma, brain tumor. Selection was limited to prospective studies involving patients given HBO followed by RT for high-grade gliomas. Data extracted from studies included the clinical research phase of the study, number of study arms, number of patients, patient age and gender, glioma type and grade, pressure and length of HBO, protocol of radiation therapy, duration of follow-up, and the outcomes.
Overall survival, time to progression, response rate, tumor regression, and toxic effects associated with HBO plus RT treatment.
Literature search/screening yielded eight studies for analysis. Six of the studies were single-arm in design and enrolled a total of 203 patients, of whom 142 had grade IV gliomas and 61 had grade III gliomas. In these six studies, all patients received HBO then RT. Two studies were double-arm in design, with 24 patients treated with HBO followed by RT and 26 patients treated with RT alone. The findings from both the single- and double-arm studies indicated improved outcomes (survival rate, progression free survival, time to progression, response rate) with HBO and RT therapy. Reported toxicity included leucopenia, anemia, thrombocytopenia, fever, loss of appetite, constipation, nausea, vomiting, and liver dysfunction. The addition of HBO had minimal effect on toxicity or side effects; across the eight studies, only one patient with severe middle ear barotrauma had a complication directly related to HBO exposure.
This systematic reviews suggests that the addition of HBO to RT is tolerated and may be beneficial in patients with high-grade gliomas.
本综述旨在评估高压氧（HBO）治疗后立即进行放射治疗（RT）对高级别胶质瘤患者的疗效和毒性。
使用以下搜索词组合在PubMed、Embase、ISI Web of Knowledge和Cochrane数据库中进行检索：放射治疗、高压氧合、化疗、胶质瘤、脑肿瘤。选择仅限于前瞻性研究，这些研究涉及给予HBO治疗后再进行RT治疗的高级别胶质瘤患者。从研究中提取的数据包括研究的临床研究阶段、研究臂数、患者数量、患者年龄和性别、胶质瘤类型和分级、HBO的压力和时长、放射治疗方案、随访时长以及结果。
总生存期、疾病进展时间、缓解率、肿瘤消退以及与HBO加RT治疗相关的毒性作用。
文献检索/筛选得到八项研究用于分析。其中六项研究为单臂设计，共纳入203例患者，其中142例为IV级胶质瘤，61例为III级胶质瘤。在这六项研究中，所有患者均接受HBO治疗后再进行RT治疗。两项研究为双臂设计，24例患者接受HBO治疗后再进行RT治疗，26例患者仅接受RT治疗。单臂和双臂研究的结果均表明，HBO和RT治疗可改善预后（生存率、无进展生存期、疾病进展时间、缓解率）。报告的毒性包括白细胞减少、贫血、血小板减少、发热、食欲不振、便秘、恶心、呕吐和肝功能障碍。添加HBO对毒性或副作用的影响极小；在八项研究中，只有一名患有严重中耳气压伤的患者出现了与HBO暴露直接相关的并发症。
本系统综述表明，在RT治疗中添加HBO是可耐受的，可能对高级别胶质瘤患者有益。
