Bennett10 - Revision history

M.bennett at 06:44, 3 January 2020

2020-01-03T06:44:54Z

M.bennett at 06:42, 3 January 2020

2020-01-03T06:42:03Z

M.bennett at 04:57, 9 July 2019

2019-07-09T04:57:26Z

Gordoben: Imported from Wikispaces

2018-12-28T04:08:18Z

Imported from Wikispaces

New page

'''Hyperbaric oxygen therapy for the treatment of late radiation tissue injury'''

**Background'''
Cancer is a significant global health problem. Radiotherapy is a treatment for many cancers and about 50% of patients having radiotherapy with be long-term survivors. Some will experience LRTI developing months or years later. HBOT has been suggested for LRTI based upon the ability to improve the blood supply to these tissues. It is postulated that HBOT may result in both healing of tissues and the prevention of problems following surgery.

**Objectives'''
To assess the benefits and harms of HBOT for treating or preventing LRTI.

**Search strategy'''
We searched The Cochrane Central Register of Controlled Trials (CENTRAL) Issue 3, 2004, MEDLINE, EMBASE, CINAHL and DORCTHIM (hyperbaric RCT register) in September 2004.

**Selection criteria'''
Randomised controlled trials (RCTs) comparing the effect of HBOT versus no HBOT on LRTI prevention or healing.

**Data collection and analysis'''
Three reviewers independently evaluated the quality of the relevant trials using the guidelines of the Cochrane Handbook [http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005005/bibliography.html#CD005005-bbs2-0018 | Clarke 2003]) and extracted the data from the included trials.

**Main results'''
Six trials contributed to this review (447 participants). For pooled analyses, investigation of heterogeneity suggested important variability between trials. From single studies there was a significantly improved chance of healing following HBOT for radiation proctitis (relative risk (RR) 2.7, 95% confidence Interval (CI) 1.2 to 6.0, P = 0.02, numbers needed to treat (NNT) = 3), and following both surgical flaps (RR 8.7, 95% CI 2.7 to 27.5, P = 0.0002, NNT = 4) and hemimandibulectomy (RR 1.4, 95% CI 1.1 to 1.8, P = 0.001, NNT = 5). There was also a significantly improved probability of healing irradiated tooth sockets following dental extraction (RR 1.4, 95% CI 1.1 to 1.7, P = 0.009, NNT = 4).

There was no evidence of benefit in clinical outcomes with established radiation injury to neural tissue, and no data reported on the use of HBOT to treat other manifestations of LRTI. These trials did not report adverse effects.

**Authors' conclusions'''
These small trials suggest that for people with LRTI affecting tissues of the head, neck, anus and rectum, HBOT is associated with improved outcome. HBOT also appears to reduce the chance of osteoradionecrosis following tooth extraction in an irradiated field. There was no such evidence of any important clinical effect on neurological tissues. The application of HBOT to selected patients and tissues may be justified. Further research is required to estabish the optimum patient selection and timing of any therapy. An economic evaluation should be also be undertaken. There is no useful information from this review regarding the efficacy or effectiveness of HBOT for other tissues.

'''Citation:'''
Bennett MH, Feldmeier J, Hampson N, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD005005.

'''Kill or update:''' December 2019

[[File:sumhorsa.gif|center]]

'''[[Radiation tissue injury | BACK]]'''

@@ Line 2: / Line 2: @@
 '''<span style="font-family: verdana,arial,helvetica; font-size: 130%;">Hyperbaric oxygen therapy for the treatment of late radiation tissue injury</span>'''
-'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Background</span>'''
+'''<span style="font-size:medium;"><span style="font-family: Arial, Helvetica, sans-serif;">Background</span></span>'''
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">Cancer is a significant global health problem. Radiotherapy is a treatment for many cancers and about 50% of patients having radiotherapy with be long-term survivors. Some will experience LRTI developing months or years later. HBOT has been suggested for LRTI based upon the ability to improve the blood supply to these tissues. It is postulated that HBOT may result in both healing of tissues and the prevention of problems following surgery.</span>
+<span style="font-size:medium;"><span style="font-family: verdana, arial, helvetica;">Cancer is a significant global health problem. Radiotherapy is a treatment for many cancers and about 50% of patients having radiotherapy with be long-term survivors. Some will experience LRTI developing months or years later. HBOT has been suggested for LRTI based upon the ability to improve the blood supply to these tissues. It is postulated that HBOT may result in both healing of tissues and the prevention of problems following surgery.</span></span>
-'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Objectives</span>'''
+'''<span style="font-size:medium;"><span style="font-family: Arial, Helvetica, sans-serif;">Objectives</span></span>'''
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">To assess the benefits and harms of HBOT for treating or preventing LRTI.</span>
+<span style="font-size:medium;"><span style="font-family: verdana, arial, helvetica;">To assess the benefits and harms of HBOT for treating or preventing LRTI.</span></span>
-'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Search strategy</span>'''
+<span style="font-size:medium;">'''<span style="font-family: Arial, Helvetica, sans-serif;">Search strategy</span>''' &nbsp;</span>
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">Randomised controlled trials (RCTs) comparing the effect of HBOT versus no HBOT on LRTI prevention or healing.</span>
+<span style="font-size:medium;">We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 11), MEDLINE, EMBASE, DORCTIHM and reference lists of articles in December 2015. We also searched for ongoing trials at clinicaltrials.gov.&nbsp;</span>
-'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Data collection and analysis</span>'''
+<span style="font-size:medium;">'''<span style="font-family: Arial, Helvetica, sans-serif;">Selection criteria</span>'''</span>
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">Three reviewers independently evaluated the quality of the relevant trials using the guidelines of the Cochrane Handbook and extracted the data from the included trials.</span>
+<span style="font-size:medium;"><span style="font-family: verdana, arial, helvetica;">Randomised controlled trials (RCTs) comparing the effect of HBOT versus no HBOT on LRTI prevention or healing.</span></span>
 <span style="font-size:medium;">Fourteen trials contributed to this review (753 participants). There was some moderate quality evidence that HBOT was more likely to achieve mucosal coverage with osteoradionecrosis (ORN) (risk ratio (RR) 1.3; 95% confidence interval (CI) 1.1 to 1.6, P value = 0.003, number needed to treat for an additional beneficial outcome (NNTB) 5; 246 participants, 3 studies). There was also moderate quality evidence of a significantly improved chance of wound breakdown without HBOT following operative treatment for ORN (RR 4.2; 95% CI 1.1 to 16.8, P value = 0.04, NNTB 4; 264 participants, 2 studies). From single studies there was a significantly increased chance of improvement or cure following HBOT for radiation proctitis (RR 1.72; 95% CI 1.0 to 2.9, P value = 0.04, NNTB 5), and following both surgical flaps (RR 8.7; 95% CI 2.7 to 27.5, P value = 0.0002, NNTB 4) and hemimandibulectomy (RR 1.4; 95% CI 1.1 to 1.8, P value = 0.001, NNTB 5). There was also a significantly improved probability of healing irradiated tooth sockets following dental extraction (RR 1.4; 95% CI 1.1 to 1.7, P value = 0.009, NNTB 4).</span>
 <span style="font-size:medium;">There was no evidence of benefit in clinical outcomes with established radiation injury to neural tissue, and no randomised data reported on the use of HBOT to treat other manifestations of LRTI. These trials did not report adverse events.</span>
-</section> </section> </article> </section>
-'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Authors' conclusions</span>'''
+<span style="font-size:medium;">'''<span style="font-family: Arial, Helvetica, sans-serif;">Authors' conclusions</span>&nbsp;'''</span>
-<section id="portlet_scolariscontentdisplay_WAR_scolariscontentdisplay"><article><section><section id="CD005005-abs1-0007">
 <span style="font-size:medium;">These small trials suggest that for people with LRTI affecting tissues of the head, neck, anus and rectum, HBOT is associated with improved outcome. HBOT also appears to reduce the chance of ORN following tooth extraction in an irradiated field. There was no such evidence of any important clinical effect on neurological tissues. The application of HBOT to selected participants and tissues may be justified. Further research is required to establish the optimum participant selection and timing of any therapy. An economic evaluation should be undertaken.</span>
-<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Kill or update:''' January 2022</span>
+<span style="font-size:medium;"><span style="font-family: Arial, Helvetica, sans-serif;">'''Citation:'''&nbsp;</span>Bennett&nbsp;&nbsp;MH, Feldmeier&nbsp;&nbsp;J, Hampson&nbsp;&nbsp;NB, Smee&nbsp;&nbsp;R, Milross&nbsp;&nbsp;C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD005005. DOI: 10.1002/14651858.CD005005.pub4.</span>
 [[File:Sumhorsa.gif|center|Sumhorsa.gif]]
 <span style="color: #7c00ff; display: block; font-family: arial,helvetica,sans-serif; font-size: 26px; text-align: center;">'''[[Radiation_tissue_injury|BACK]]'''</span>

@@ Line 6: / Line 6: @@
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">Cancer is a significant global health problem. Radiotherapy is a treatment for many cancers and about 50% of patients having radiotherapy with be long-term survivors. Some will experience LRTI developing months or years later. HBOT has been suggested for LRTI based upon the ability to improve the blood supply to these tissues. It is postulated that HBOT may result in both healing of tissues and the prevention of problems following surgery.</span>
 '''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Objectives</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">To assess the benefits and harms of HBOT for treating or preventing LRTI.</span>
 '''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Search strategy</span>'''
+<section id="portlet_scolariscontentdisplay_WAR_scolariscontentdisplay"><article><section><section id="CD005005-abs1-0003">
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">We searched The Cochrane Central Register of Controlled Trials (CENTRAL) Issue 3, 2004, MEDLINE, EMBASE, CINAHL and DORCTHIM (hyperbaric RCT register) in September 2004.</span>
+<span style="font-size:medium;">We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 11), MEDLINE, EMBASE, DORCTIHM and reference lists of articles in December 2015. We also searched for ongoing trials at clinicaltrials.gov.</span>
+</section> </section> </article> </section>
 '''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Selection criteria</span>'''
@@ Line 20: / Line 20: @@
 '''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Data collection and analysis</span>'''
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">Three reviewers independently evaluated the quality of the relevant trials using the guidelines of the Cochrane Handbook [http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005005/bibliography.html#CD005005-bbs2-0018 | Clarke 2003]) and extracted the data from the included trials.</span>
+<span style="font-family: verdana,arial,helvetica; font-size: 120%;">Three reviewers independently evaluated the quality of the relevant trials using the guidelines of the Cochrane Handbook and extracted the data from the included trials.</span>
 '''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Main results</span>'''
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">Six trials contributed to this review (447 participants). For pooled analyses, investigation of heterogeneity suggested important variability between trials. From single studies there was a significantly improved chance of healing following HBOT for radiation proctitis (relative risk (RR) 2.7, 95% confidence Interval (CI) 1.2 to 6.0, P = 0.02, numbers needed to treat (NNT) = 3), and following both surgical flaps (RR 8.7, 95% CI 2.7 to 27.5, P = 0.0002, NNT = 4) and hemimandibulectomy (RR 1.4, 95% CI 1.1 to 1.8, P = 0.001, NNT = 5). There was also a significantly improved probability of healing irradiated tooth sockets following dental extraction (RR 1.4, 95% CI 1.1 to 1.7, P = 0.009, NNT = 4).</span>
+<span style="font-size:medium;">There was no evidence of benefit in clinical outcomes with established radiation injury to neural tissue, and no randomised data reported on the use of HBOT to treat other manifestations of LRTI. These trials did not report adverse events.</span>
+</section> </section> </article> </section>
 '''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Authors' conclusions</span>'''
-<span style="font-family: verdana,arial,helvetica; font-size: 120%;">These small trials suggest that for people with LRTI affecting tissues of the head, neck, anus and rectum, HBOT is associated with improved outcome. HBOT also appears to reduce the chance of osteoradionecrosis following tooth extraction in an irradiated field. There was no such evidence of any important clinical effect on neurological tissues. The application of HBOT to selected patients and tissues may be justified. Further research is required to estabish the optimum patient selection and timing of any therapy. An economic evaluation should be also be undertaken. There is no useful information from this review regarding the efficacy or effectiveness of HBOT for other tissues.</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Kill or update:''' January 2022</span>
 [[File:Sumhorsa.gif|center|Sumhorsa.gif]]
 <span style="color: #7c00ff; display: block; font-family: arial,helvetica,sans-serif; font-size: 26px; text-align: center;">'''[[Radiation_tissue_injury|BACK]]'''</span>

@@ Line 1: / Line 1: @@
 '''<span style="font-family: verdana,arial,helvetica; font-size: 130%;">Hyperbaric oxygen therapy for the treatment of late radiation tissue injury</span>'''
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Background</span>'''
+'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Background</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">Cancer is a significant global health problem. Radiotherapy is a treatment for many cancers and about 50% of patients having radiotherapy with be long-term survivors. Some will experience LRTI developing months or years later. HBOT has been suggested for LRTI based upon the ability to improve the blood supply to these tissues. It is postulated that HBOT may result in both healing of tissues and the prevention of problems following surgery.</span>
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Objectives</span>'''
+'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Objectives</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">To assess the benefits and harms of HBOT for treating or preventing LRTI.</span>
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Search strategy</span>'''
+'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Search strategy</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">We searched The Cochrane Central Register of Controlled Trials (CENTRAL) Issue 3, 2004, MEDLINE, EMBASE, CINAHL and DORCTHIM (hyperbaric RCT register) in September 2004.</span>
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Selection criteria</span>'''
+'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Selection criteria</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">Randomised controlled trials (RCTs) comparing the effect of HBOT versus no HBOT on LRTI prevention or healing.</span>
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Data collection and analysis</span>'''
+'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Data collection and analysis</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">Three reviewers independently evaluated the quality of the relevant trials using the guidelines of the Cochrane Handbook [http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005005/bibliography.html#CD005005-bbs2-0018 | Clarke 2003]) and extracted the data from the included trials.</span>
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Main results</span>'''
+'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Main results</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">Six trials contributed to this review (447 participants). For pooled analyses, investigation of heterogeneity suggested important variability between trials. From single studies there was a significantly improved chance of healing following HBOT for radiation proctitis (relative risk (RR) 2.7, 95% confidence Interval (CI) 1.2 to 6.0, P = 0.02, numbers needed to treat (NNT) = 3), and following both surgical flaps (RR 8.7, 95% CI 2.7 to 27.5, P = 0.0002, NNT = 4) and hemimandibulectomy (RR 1.4, 95% CI 1.1 to 1.8, P = 0.001, NNT = 5). There was also a significantly improved probability of healing irradiated tooth sockets following dental extraction (RR 1.4, 95% CI 1.1 to 1.7, P = 0.009, NNT = 4).</span>
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">There was no evidence of benefit in clinical outcomes with established radiation injury to neural tissue, and no data reported on the use of HBOT to treat other manifestations of LRTI. These trials did not report adverse effects.</span>
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Authors' conclusions</span>'''
+'''<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Authors' conclusions</span>'''
 <span style="font-family: verdana,arial,helvetica; font-size: 120%;">These small trials suggest that for people with LRTI affecting tissues of the head, neck, anus and rectum, HBOT is associated with improved outcome. HBOT also appears to reduce the chance of osteoradionecrosis following tooth extraction in an irradiated field. There was no such evidence of any important clinical effect on neurological tissues. The application of HBOT to selected patients and tissues may be justified. Further research is required to estabish the optimum patient selection and timing of any therapy. An economic evaluation should be also be undertaken. There is no useful information from this review regarding the efficacy or effectiveness of HBOT for other tissues.</span>
-<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Bennett MH, Feldmeier J, Hampson N, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD005005.</span>
 <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Kill or update:''' December 2019</span>
-[[File:sumhorsa.gif|center]]
+[[File:Sumhorsa.gif|center|Sumhorsa.gif]]
-<span style="color: #7c00ff; display: block; font-family: arial,helvetica,sans-serif; font-size: 26px; text-align: center;">'''[[Radiation tissue injury  |  BACK]]'''</span>
+<span style="color: #7c00ff; display: block; font-family: arial,helvetica,sans-serif; font-size: 26px; text-align: center;">'''[[Radiation_tissue_injury|BACK]]'''</span>