Salmón-González Zaida, Anchuelo Javier, Borregán Juan C, Del Real Alvaro, Riancho José A, Valero Carmen
Department of Internal Medicine, Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria, Santander, Spain.
Service of Radiation Oncology, Hospital Marqués de Valdecilla, Santander, Spain.
Rep Pract Oncol Radiother. 2021 Apr 14;26(2):163-169. doi: 10.5603/RPOR.a2021.0022. eCollection 2021.
Hyperbaric oxygen therapy (HBOT) is useful in the treatment of complications due to radiotherapy in patients with neoplasm. Its effects on bone metabolism are unclear. In our study, we analyzed the effects of HBOT on bone remodeling in oncological patients with radiotherapy.
Prospective clinical study in 23 patients with neoplasms undergoing treatment with HBOT due to complications of radiotherapy (hemorrhagic cystitis, proctitis or radionecrosis) and 25 patients with chronic anal fissure. The average number of HBOT sessions was 20 ± 5 (100% oxygen, 2.3 atmospheres and 90 min per day). Serum levels of aminoterminal propeptide of type I collagen (P1NP), C terminal telopeptide of type I collagen (CTX), alkaline phosphatase (AP), 25hydroxyvitamin D (25-OHD), parathyroid hormone (PTH), were measured at 3 time points: T0 (before beginning HBOT), T1 (at the end of HBOT) and T2 (6 months after HBOT).
At baseline, the patients with neoplasm have higher bone turnover than those with anal fissure. These differences were 41% in CTX (0.238 ± 0.202 ng/mL in neoplasm and 0.141 ± 0.116 ng/mL in fissure; p = 0.04), 30% for PTH (46 ± 36 pg/mL in neoplasm and 32 ± 17 pg/mL in fissure; p = 0.04) and 15% for alkaline phosphatase (80 ± 24 U/L in neoplasm and 68 ± 16 U/L in fissure; p = 0.04). In the group with neoplasm, the values of P1NP decreased 6% after HBOT (T0: 49 ± 31 ng/mL, T2: 46 ± 12 ng/mL; p = 0.03). Also, there were non-significant decreases in PTH (-34%) and CTX (-30%).
Patients with neoplasm and complications with radiotherapy have an increase in bone remodeling that may be diminished after HBOT.
高压氧疗法（HBOT）在治疗肿瘤患者放疗并发症方面有用。其对骨代谢的影响尚不清楚。在我们的研究中，我们分析了HBOT对接受放疗的肿瘤患者骨重塑的影响。
对23例因放疗并发症（出血性膀胱炎、直肠炎或放射性坏死）接受HBOT治疗的肿瘤患者和25例慢性肛裂患者进行前瞻性临床研究。HBOT治疗的平均次数为20±5次（100%氧气，2.3个大气压，每天90分钟）。在3个时间点测量血清I型胶原氨基端前肽（P1NP）、I型胶原C末端端肽（CTX）、碱性磷酸酶（AP）、25-羟基维生素D（25-OHD）、甲状旁腺激素（PTH）水平：T0（HBOT开始前）、T1（HBOT结束时）和T2（HBOT后6个月）。
基线时，肿瘤患者的骨转换率高于肛裂患者。这些差异在CTX中为41%（肿瘤患者为0.238±0.202 ng/mL，肛裂患者为0.141±0.116 ng/mL；p = 0.04），PTH为30%（肿瘤患者为46±36 pg/mL，肛裂患者为32±17 pg/mL；p = 0.04），碱性磷酸酶为15%（肿瘤患者为80±24 U/L，肛裂患者为68±16 U/L；p = 0.04）。在肿瘤患者组中，HBOT后P1NP值下降了6%（T0：49±31 ng/mL，T2：46±12 ng/mL；p = 0.03）。此外，PTH（-34%）和CTX（-30%）也有不显著的下降。
患有肿瘤且有放疗并发症的患者骨重塑增加，HBOT后可能会减轻。
