Chitapanarux Imjai, Onchan Wimrak, Chakrabandhu Somvilai, Muangwong Pooriwat, Autsavapromporn Narongchai, Ariyanon Tapanut, Akagi Junji, Mizoo Akira
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Division of Head and Neck Surgery and Oncology and Hyperbaric Oxygen Therapy, Department of Otolaryngology, Chiang Mai University, Chiang Mai, Thailand.
Onco Targets Ther. 2024 Oct 29;17:863-870. doi: 10.2147/OTT.S478613. eCollection 2024.
Hydrogen (H) gas inhalation might alleviate acute radiotherapy toxicities by scavenging free radicals produced by ionizing radiation and anti-inflammatory properties. This study aimed to investigate the feasibility and safety of H gas inhalation during concurrent chemoradiotherapy (CCRT) in patients with locally advanced head and neck cancer (LAHNC).
We designed a pilot prospective study combining CCRT with aerosol inhalation of H gas. Each patient was scheduled to receive daily intensity-modulated radiotherapy (IMRT) in 33 fractions on a weekday and six cycles of weekly chemotherapy. All patients inhaled H gas through a cannula or mask 1 hour per day, 1-2 hours before IMRT. The primary endpoint was the feasibility of H inhalation. Eighty percent of the patients who completed at least 20 applications of H gas inhalation were considered feasible. The secondary endpoints were safety profiles during H gas inhalation (vital signs and symptoms related to H gas inhalation) and acute toxicities during CCRT.
We enrolled 10 patients with LAHNC between July 2023 and December 2023. All patients received 33 fractions of H gas inhalation on the same day as the IMRT. Vital signs during and at the end of H gas inhalation were stable in all patients. None of the 10 patients had hypertension or hypotension during any of the 33 inhalations. No adverse events related to H gas inhalation, such as cough, nasal bleeding, dizziness, headache, nausea, or vomiting, were reported. Grade 3 leukopenia was found in two patients (20%) during the 5th week of CCRT. Grade 2 radiation dermatitis and pharyngitis were found in three patients (30%).
H gas inhalation combined with CCRT is feasible and safe for patients with LAHNC.
氢气吸入可能通过清除电离辐射产生的自由基和抗炎特性来减轻急性放疗毒性。本研究旨在探讨局部晚期头颈癌（LAHNC）患者在同步放化疗（CCRT）期间吸入氢气的可行性和安全性。
我们设计了一项前瞻性试点研究，将CCRT与氢气雾化吸入相结合。每位患者计划在工作日接受33次分割的每日调强放疗（IMRT）以及六个周期的每周化疗。所有患者每天通过插管或面罩吸入氢气1小时，在IMRT前1 - 2小时进行。主要终点是氢气吸入的可行性。完成至少20次氢气吸入应用的患者中，80%被认为是可行的。次要终点是氢气吸入期间的安全性（生命体征和与氢气吸入相关的症状）以及CCRT期间的急性毒性。
我们在2023年7月至2023年12月期间招募了10例LAHNC患者。所有患者在IMRT当天接受33次氢气吸入。所有患者在氢气吸入期间及结束时生命体征稳定。10例患者在33次吸入中的任何一次均未出现高血压或低血压。未报告与氢气吸入相关的不良事件，如咳嗽、鼻出血、头晕、头痛、恶心或呕吐。在CCRT第5周时，2例患者（20%）出现3级白细胞减少。3例患者（30%）出现2级放射性皮炎和咽炎。
对于LAHNC患者，氢气吸入联合CCRT是可行且安全的。
