Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

Glassburn
1974 111
Johnson
1974 112
Ward 1974 113
n=17
Comparison therapy original protocol.
Modified protocol: 4,000 rad tumour dose in 10
fractions over five weeks at a rate of 400 rad per
treatment twice weekly. Stage IIIa to IVa: 400 rad
booster dose to the lateral pelvic wall.
Treatment in a monoplace HBO chamber at 3
ATA for 40 minutes.
n=25
Comparison therapy plus HBOT. †
n=23
Comparison therapy plus treatment in a
monoplace HBO chamber at 3 ATA for 30
minutes.
* Abbreviations: ATA = atmosphere absolute, n = sample size.
† Therapy not described.
n=23
Original protocol: 250 rad per treatment session,
four times a week, 1,000 rad per week, for a total
of 5,000 rad. Stage IIIa and IIIb: 1,000 rad
booster to lateral pelvic structures.
Modified protocol: 5,000 rad tumour dose in 10
fractions over five weeks at a rate of 200 rad per
treatment five times a week. Stage IIIa to IVa: 500
rad booster dose to the lateral pelvic wall.
n=39
Three groups with a minimum dose of 6,000 rad
in 30 fractions over 6 weeks. Stage IIIa: 500 rad
booster dose to the lateral pelvic wall in two
treatments with a single radium application of
3,000 to 4,500 mg-hrs and a maximum rectal
dose of 8,000 rad. Stage IIIb: 6,000 rad minimum
dose with single radium application of 1,500 to
2,000 mg-hrs.
n=22
Two-point tissue doses of 6,000 and 3,950 rad.
Rectal dose of 5,000 rad.
Comparison therapies were not standardised across studies. Most applied overlapping
radiotherapy exposures over a variable number of fractions and duration of therapies.
The subjects were not placed in HBO chambers.
Assessment of heterogeneity
This review does not attempt to arrive at a common effect estimate through statistical
methods due to the inadequacy with which study populations, methodologies, and
intervention and comparison protocols were described. Instead, the results of each study
are described below.
Review of published clinical experience
In the five-year follow-up published by Brady et al, 108 no statistically significant
differences between intervention and comparison groups in terms of disease and
complication-free survival, median duration, and survival proportions at the end of
follow-up (Table 69).
Table 69 Outcomes following treatment for cervical cancer in intervention and comparison groups
(Brady et al). 108
Outcome
Disease and complication free survival (%)
Overall
Stage IIb
Stage IIIb
Stage IVa
Intervention Group
(n = 29)
Comparison Group
(n = 29)
70 Hyperbaric oxygen therapy
48.3
64.3
35.7
0.0
Median duration (years) 4.0 2.5
48.3
42.8
53.8
50.0
p
1.0000
0.2556
0.3434
Proportion surviving to 5 years (%) 45.0 46.0 0.9390