Bennett4 - Revision history

M.bennett at 06:34, 3 January 2020

2020-01-03T06:34:28Z

M.bennett at 06:33, 3 January 2020

2020-01-03T06:33:04Z

M.bennett at 06:31, 3 January 2020

2020-01-03T06:31:42Z

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'''Hyperbaric oxygenation for tumour sensitisation to radiotherapy'''
'''Citation:''' Bennett MH, Feldmeier J, Smee R, Milross C. Hyperbaric oxygenation for tumour sensitisation to radiotherapy. Cochrane Database of Systematic Reviews 2012, Issue 4. Art. No.: CD005007.

**Abstract'''
Background
Cancer is common and radiotherapy is one well-established treatment for some solid tumours. HBO may improve the ability of radiotherapy to kill hypoxic cancer cells, so the administration of radiotherapy while breathing HBO may result in a reduction in mortality and tumour recurrence.
Objectives
To assess the benefits and harms of radiotherapy while breathing HBO.
Search strategy
In November 2004 we searched The Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library Issue 3), MEDLINE, EMBASE , CINAHL, DORCTHIM and reference lists of articles. Relevant journals were handsearched.
Selection criteria
Randomised and quasi-randomised studies comparing the outcome of malignant tumours following radiation therapy while breathing HBO versus air (with or without sham therapy).
Data collection and analysis
Three reviewers independently evaluated the quality of the relevant trials using the method of Schulz (Schulz 1995) and extracted the data from the included trials.
Main results
Nineteen trials contributed to this review (2286 patients: 1103 allocated to HBO and 1153 control). With HBO, there was a reduction in mortality for head and neck cancers at both one year and five years after therapy (Relative risk (RR) 0.83, P = 0.03, number needed to treat (NNT) = 11 and RR 0.82, P = 0.03, NNT = 5 respectively), as well as improved local tumour control at three months (RR with HBOT 0.58, P = 0.006, NNT = 7). The effect of HBO varied with different fractionation schemes. Local tumour recurrence was less likely with HBO at one year (head and neck, RR 0.66, P < 0.0001, NNT = 5), two years (uterine cervix RR 0.60, P = 0.04, NNT = 5) and five years (head and neck (RR 0.77, P = 0.01). Any advantage is achieved at the cost of some adverse effects. There was a significant increase in the rate of both severe radiation tissue injury (RR 2.35, P < 0.0001, (number needed to harm (NNH) = 8) and the chance of seizures during therapy (RR 6.76, P = 0.03, NNH 22) with HBO.
Authors' conclusions
There is some evidence that HBO improves local tumour control and mortality for cancers of the head and neck, and local tumour recurrence in cancers of the head and neck, and uterine cervix. These benefits may only occur with unusual fractionation schemes. HBO is associated with significant adverse effects including oxygen toxic seizures and severe tissue radiation injury. The methodological and reporting inadequacies of the primary studies included in this review demand a cautious interpretation. More research is needed for head and neck cancer, but is probably not justified for bladder cancer. There is little evidence available concerning malignancies at other anatomical sites on which to base a recommendation.



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'''[[Radiotherapy enhancement | BACK]]'''

@@ Line 2: / Line 2: @@
 <span style="display: block; text-align: left;"><span style="font-size:x-large;"><span class="article-title" style="font-family: Arial, Helvetica, sans-serif;">'''Hyperbaric oxygenation for tumour sensitisation to radiotherapy'''</span></span></span>
-<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''</span><span style="font-size:small;">Bennett&nbsp;&nbsp;MH, Feldmeier&nbsp;&nbsp;J, Smee&nbsp;&nbsp;R, Milross&nbsp;&nbsp;C. Hyperbaric oxygenation for tumour sensitisation to radiotherapy. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD005007. DOI: 10.1002/14651858.CD005007.pub</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:&nbsp;'''</span><span style="font-size:small;">Bennett&nbsp;&nbsp;MH, Feldmeier&nbsp;&nbsp;J, Smee&nbsp;&nbsp;R, Milross&nbsp;&nbsp;C. Hyperbaric oxygenation for tumour sensitisation to radiotherapy. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD005007. DOI: 10.1002/14651858.CD005007.pub</span>
 <span style="font-size:large;">Background</span>
@@ Line 12: / Line 12: @@
 To assess the benefits and harms of administering radiotherapy for the treatment of malignant tumours while breathing HBO.&nbsp;
-=== <span style="font-size:large;">Search methods</span> ===
+<span style="font-size:large;">Search methods</span>
 In September 2017 we searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library Issue 8, 2017, MEDLINE, Embase, and the Database of Randomised Trials in Hyperbaric Medicine using the same strategies used in 2011 and 2015, and examined the reference lists of included articles.

@@ Line 2: / Line 2: @@
 <span style="display: block; text-align: left;"><span style="font-size:x-large;"><span class="article-title" style="font-family: Arial, Helvetica, sans-serif;">'''Hyperbaric oxygenation for tumour sensitisation to radiotherapy'''</span></span></span>
-<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''<span style="font-size:medium;"></span></span><span style="font-size:small;">Bennett&nbsp;&nbsp;MH, Feldmeier&nbsp;&nbsp;J, Smee&nbsp;&nbsp;R, Milross&nbsp;&nbsp;C. Hyperbaric oxygenation for tumour sensitisation to radiotherapy. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD005007. DOI: 10.1002/14651858.CD005007.pub</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''</span><span style="font-size:small;">Bennett&nbsp;&nbsp;MH, Feldmeier&nbsp;&nbsp;J, Smee&nbsp;&nbsp;R, Milross&nbsp;&nbsp;C. Hyperbaric oxygenation for tumour sensitisation to radiotherapy. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD005007. DOI: 10.1002/14651858.CD005007.pub</span>
 <span style="font-size:large;">Background</span>
@@ Line 8: / Line 8: @@
 Cancer is a common disease and radiotherapy is one well‐established treatment for some solid tumours. Hyperbaric oxygenation therapy (HBOT) may improve the ability of radiotherapy to kill hypoxic cancer cells, so the administration of radiotherapy while breathing hyperbaric oxygen may result in a reduction in mortality and recurrence.
-<span style="font-size:large;">Objectives</span>
+<span style="font-size:large;">Objectives</span>&nbsp;
-<section id="portlet_scolariscontentdisplay_WAR_scolariscontentdisplay"><article><section><section id="CD005007-abs1-0002">
-To assess the benefits and harms of administering radiotherapy for the treatment of malignant tumours while breathing HBO.
+To assess the benefits and harms of administering radiotherapy for the treatment of malignant tumours while breathing HBO.&nbsp;
-</section> <section id="CD005007-abs1-0003">
 === <span style="font-size:large;">Search methods</span> ===
 In September 2017 we searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library Issue 8, 2017, MEDLINE, Embase, and the Database of Randomised Trials in Hyperbaric Medicine using the same strategies used in 2011 and 2015, and examined the reference lists of included articles.
-</section> <section id="CD005007-abs1-0004">
 === <span style="font-size:large;">Selection criteria</span> ===
-Randomised and quasi‐randomised studies comparing the outcome of malignant tumours following radiation therapy while breathing HBO versus air or an alternative sensitising agent.
+Randomised and quasi‐randomised studies comparing the outcome of malignant tumours following radiation therapy while breathing HBO versus air or an alternative sensitising agent.&nbsp;
-</section> <section id="CD005007-abs1-0005">
 === <span style="font-size:large;">Data collection and analysis</span> ===
-Three review authors independently evaluated the quality of and extracted data from the included trials.
+Three review authors independently evaluated the quality of and extracted data from the included trials.&nbsp;
-</section> <section id="CD005007-abs1-0006">
 === <span style="font-size:large;">Main results</span> ===
@@ Line 34: / Line 34: @@
 With regard to the treatment of urinary bladder cancer, there was no clear evidence of a benefit in terms of mortality from HBOT at one year (RR 0.97, 95% CI 0.74 to 1.27, high‐quality evidence), nor any benefit in the risk of developing metastases at two years (RR 2.0, 95% CI 0.58 to 6.91, moderate‐quality evidence due to imprecision). No trial reported on failure of local control, local recurrence, quality of life, or adverse effects.
-When all cancer types were combined, there was evidence for an increased risk of severe radiation tissue injury during the course of radiotherapy with HBOT (RR 2.35, 95% CI 1.66 to 3.33, high‐quality evidence) and of oxygen toxic seizures during treatment (RR with HBOT 6.76, 96% CI 1.16 to 39.31, moderate‐quality evidence due to imprecision).
+When all cancer types were combined, there was evidence for an increased risk of severe radiation tissue injury during the course of radiotherapy with HBOT (RR 2.35, 95% CI 1.66 to 3.33, high‐quality evidence) and of oxygen toxic seizures during treatment (RR with HBOT 6.76, 96% CI 1.16 to 39.31, moderate‐quality evidence due to imprecision). </section> <section id="CD005007-abs1-0007">
 </section> <section id="CD005007-abs1-0007">
 === <span style="font-size:large;">Authors' conclusions</span> ===
 We found evidence that HBOT improves local tumour control, mortality, and local tumour recurrence for cancers of the head and neck. These benefits may only occur with unusual fractionation schemes. Hyperbaric oxygenation therapy is associated with severe tissue radiation injury. Given the methodological and reporting inadequacies of the included studies, our results demand a cautious interpretation. More research is needed for head and neck cancer, but is probably not justified for uterine cervical or bladder cancer. There is little evidence available concerning malignancies at other anatomical sites.
 <span style="display: block; text-align: center;">[[File:Sumhorsa.gif|RTENOTITLE]]</span>
 <span style="display: block; text-align: center;"><span style="color: #7c00ff; display: block; text-align: center;">'''<span style="color: #7c00ff; font-size: 24px;">[[Radiotherapy_enhancement|BACK]]</span>'''</span></span>

@@ Line 1: / Line 1: @@
-**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span class="sect1">Abstract</span></span>'''
+<span style="display: block; text-align: left;"><span style="font-size:x-large;"><span class="article-title" style="font-family: Arial, Helvetica, sans-serif;">'''Hyperbaric oxygenation for tumour sensitisation to radiotherapy'''</span></span></span>
-</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''<span style="font-size:medium;"></span></span><span style="font-size:small;">Bennett&nbsp;&nbsp;MH, Feldmeier&nbsp;&nbsp;J, Smee&nbsp;&nbsp;R, Milross&nbsp;&nbsp;C. Hyperbaric oxygenation for tumour sensitisation to radiotherapy. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD005007. DOI: 10.1002/14651858.CD005007.pub</span>
-<span style="display: block; text-align: center;">[[File:sumhorsa.gif]]</span>
+<span style="font-size:large;">Background</span>
-</span><span style="display: block; text-align: center;"><span style="color: #7c00ff; display: block; text-align: center;">'''<span style="color: #7c00ff; font-size: 24px;">[[Radiotherapy enhancement  |  BACK]]</span>'''</span></span>
+Cancer is a common disease and radiotherapy is one well‐established treatment for some solid tumours. Hyperbaric oxygenation therapy (HBOT) may improve the ability of radiotherapy to kill hypoxic cancer cells, so the administration of radiotherapy while breathing hyperbaric oxygen may result in a reduction in mortality and recurrence.