Hyperbaric oxygen therapy for late toxicity after radiotherapy for breast cancer

Although the percentage of patients willing to undergo hyperbaric oxygen therapy (HBOT) was low, this treatment appears effective in reducing pain and fibrosis in women with late local toxicity after radiotherapy for breast cancer. This is the conclusion of Dutch researchers JAMA Oncology.

Between 2019 and 2022, 189 women were included with moderate or severe breast, chest wall and/or shoulder pain in combination with edema, fibrosis or movement limitation ≥ 12 months after radiotherapy for breast cancer. 125 women were offered HBOT (30-40 sessions over 6-8 weeks) and 61 participants were assigned to the control group. The primary endpoint was chest, chest wall and/or shoulder pain 6 months after randomization. Secondary endpoints were fibrosis, edema, movement limitation and quality of life.

Of those offered HBOT, 25% accepted and completed treatment. The most common reason for not accepting HBOT was the high treatment intensity. In the ITT analysis, moderate or severe pain during follow-up was reported by 58/115 women (50%) in the intervention group and by 32/52 women (62%) in the control group (OR 0.63; p = 0. 18). In the complier average causal effect (CACE) analysis, the proportion of women reporting moderate or severe pain during follow-up was 32% (10/31) among those who completed HBOT and 75% (9.7/12.9) among control participants expected to complete HBOT if offered (adjusted OR 0.34; p = 0.01). In the ITT analysis, moderate or severe fibrosis was reported by 35/107 participants (33%) in the intervention group and by 25/49 (51%) in the control group (OR 0.36; p = 0.02). There were no significant differences in edema, movement limitation and quality of life between the groups.

source:

Mink van der Molen DR, Batenburg MC, Maarse W, et al. Hyperbaric Oxygen Therapy and Late Local Toxic Effects in Patients With Irradiated Breast Cancer: A Randomized Clinical Trial. JAMA Oncol. 2024 Feb 8. Online ahead of print.