Hyperbaric Oxygen Therapy after adjuvant radiotherapy reduces fibrosis in breast cancer patients: JAMA

A recent randomized clinical trial published in the Journal of American Medical Association investigated the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in treating late local toxic effects experienced by women who underwent adjuvant radiotherapy for breast cancer. The trial from the UMBRELLA cohort study assess the impact of HBOT on pain, fibrosis, edema, movement restriction, and overall quality of life.

This trial was conducted in the Netherlands and involved a total of 189 women who were experiencing moderate to severe breast, chest wall, and/or shoulder pain, along with other symptoms, 12 months or more after breast irradiation. The participants were offered 30 to 40 HBOT sessions over 6 to 8 consecutive weeks. The pain levels were assessed using the European Organization for Research and Treatment of Cancer QLQ-BR23 questionnaire, while other symptoms assessed were the overall quality of life.

The trial found that while HBOT did not significantly reduce pain levels overall, it was effective in reducing fibrosis. Among women who completed HBOT, there was a significant reduction in both pain and fibrosis. Only 25% of women who were offered HBOT opted to undergo the treatment, with the main reason for refusal being mentioned as the high intensity of the therapy.

The outcomes suggest that while HBOT may not be universally effective in alleviating pain associated with late local toxic effects after breast irradiation, but, it shows promise in reducing fibrosis. The relatively low acceptance rate among participants indicates a need for further comprehensive investigation into the feasibility and acceptability of HBOT.

Reference:

Mink van der Molen, D. R., Batenburg, M. C. T., Maarse, W., van den Bongard, D. H. J. G., Doeksen, A., de Lange, M. Y., van der Pol, C. C., Evers, D. J., Lansdorp, C. A., van der Laan, J., van de Ven, P. M., van der Leij, F., & Verkooijen, H. M. (2024). Hyperbaric Oxygen Therapy and Late Local Toxic Effects in Patients With Irradiated Breast Cancer. In JAMA Oncology. American Medical Association (AMA). https://doi.org/10.1001/jamaoncol.2023.6776

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