Sidik

Hyperbaric oxygen administration decreased side effects and improved quality of life after pelvic irradiation in women.

Bottom line

1. Hyperbaric oxygen improved symptoms and signs of radiation proctitis in women following pelvic irradiation for cervical cancer.
2. There was an improvement in both proctosopic and histological findings following HBOT.

Citations 1. Sidik S, Hardjodisastro D, Setiabudy R, Gondowiardjo S. Does hyperbaric oxygen administration decrease side effect and improve quality of life after pelvic radiation? Acta Med Indones 2007;39(4):169-173. 2. Sidik S, Daldiyono H, Setiabudy R, Gondowiardjo S, Yoewona V. Oxygen hyperbaric therapy in patients with radiation proctitis. The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy 2007;8(1):1-4.

Three-part clinical question For patients with radiation proctitis following radiotherapy for cervical cancer, does hyperbaric oxygen therapy result in improvement of quality of life and objective evidence of radiation proctitis?

Search Terms Hyperbaric oxygen therapy, radiation proctitis, quality of life

The study Non-blinded randomised controlled trial, intention to treat unclear

The study patients Adult females (<55 years) with cervical cancer stages I – IIIB and irradiation (ex beam and brachytherapy) who had radiation proctitis 1 to 6 months after radiotherapy.

Control group: (n=40, 20 analysed) received standard care (not defined),

Experimental group: (n=35, 26 analysed) as above plus HBOT (regimen not given but minimum 18 sessions).

 

The evidence:

Outcome	Time to outcome	Control Group	Experimental Group	P value
Absence of radiation proctitis	6 months	9/20 (45%)	20/26 (77%)	0.03 (NNT 3)

Non-event outcomes

Outcome	Time to outcome	Control Group	Experimental Group	P value
Percentage change in LENT SOMA Score compared to before intervention	After intervention	44.1+/- 28.2	0.71 +/- 30.2	< 0.001
Percentage change in LENT SOMA Score compared to before intervention	6 months	33.6 +/- 57.6	-19.7 +/- 69.4	0.008
Percentage change in Karnofsky Score compared to before intervention	After intervention	19.7 +/- 9.6	4.5 +/- 10.7	< 0.001
Percentage change in Karnofsky Score compared to before intervention	6 months	15.3 +/- 14.7	2.47 +/- 16.11	0.007

Comments .

1. High drop-out rate due to intolerance of HBOT (7) and long travel distances, and high loss to follow-up with 15 deaths by six months.
2. No definition of ‘standard therapy’. HBOT was probably between 2 and 3 ATA for 2 hours as discussed in the introduction
3. Quality of life outcomes reported as percentage change from baseline, rather than raw scores.

Appraised by: D. Smart Saturday 20th August 2011 Email : [dsmart@utas.edu.au]

Update by: December 2020

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