PMID- 36404528
OWN - NLM
STAT- MEDLINE
DCOM- 20221220
LR  - 20240201
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Print)
IS  - 0167-8140 (Linking)
VI  - 177
DP  - 2022 Dec
TI  - Sensitizing brain metastases to stereotactic radiosurgery using hyperbaric 
      oxygen: A proof-of-principle study.
PG  - 179-184
LID - S0167-8140(22)04520-0 [pii]
LID - 10.1016/j.radonc.2022.10.024 [doi]
AB  - PURPOSE: Increased oxygen levels may enhance the radiosensitivity of brain 
      metastases treated with stereotactic radiosurgery (SRS). This project 
      administered hyperbaric oxygen (HBO) prior to SRS to assess feasibility, safety, 
      and response. METHODS: 38 patients were studied, 19 with 25 brain metastases 
      treated with HBO prior to SRS, and 19 historical controls with 27 metastases, 
      matched for histology, GPA, resection status, and lesion size. Outcomes included 
      time from HBO to SRS, quality-of-life (QOL) measures, local control, distant 
      (brain) metastases, radionecrosis, and overall survival. RESULTS: The average 
      time from HBO chamber to SRS beam-on was 8.3 +/- 1.7 minutes. Solicited adverse 
      events (AEs) were comparable between HBO and control patients; no grade III or IV 
      serious AEs were observed. Radionecrosis-free survival (RNFS), radionecrosis-free 
      survival before whole-brain radiation therapy (WBRT) (RNBWFS), local 
      recurrence-free survival before WBRT (LRBWFS), distant recurrence-free survival 
      before WBRT (DRBWFS), and overall survival (OS) were not significantly different 
      for HBO patients and controls on Kaplan-Meier analysis, though at 1-year 
      estimated survival rates trended in favor of SRS + HBO: RNFS - 83% vs 60%; RNBWFS 
      - 78% vs 60%; LRBWFS - 95% vs 78%; DRBWFS - 61% vs 57%; and OS - 73% vs 56%. 
      Multivariate Cox models indicated no significant association between HBO 
      treatment and hazards of RN, local or distant recurrence, or mortality; however, 
      these did show statistically significant associations (p < 0.05) for: local 
      recurrence with higher volume, radionecrosis with tumor resection, overall 
      survival with resection, and overall survival with higher GPA. CONCLUSION: 
      Addition of HBO to SRS for brain metastases is feasible without evident decrement 
      in radiation necrosis and other clinical outcomes.
CI  - Copyright (c) 2022. Published by Elsevier B.V.
FAU - Hartford, Alan C
AU  - Hartford AC
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA. Electronic address: Alan.C.Hartford@Hitchcock.org.
FAU - Gill, Gobind S
AU  - Gill GS
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
FAU - Ravi, Divya
AU  - Ravi D
AD  - Dartmouth Cancer Center, One Medical Center Drive, Lebanon, NH 03756, USA.
FAU - Tosteson, Tor D
AU  - Tosteson TD
AD  - Dartmouth Cancer Center, One Medical Center Drive, Lebanon, NH 03756, USA. 
      Electronic address: Tor.D.Tosteson@Dartmouth.edu.
FAU - Li, Zhongze
AU  - Li Z
AD  - Dartmouth Cancer Center, One Medical Center Drive, Lebanon, NH 03756, USA.
FAU - Russo, Gregory
AU  - Russo G
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
FAU - Eskey, Clifford J
AU  - Eskey CJ
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
FAU - Jarvis, Lesley A
AU  - Jarvis LA
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
FAU - Simmons, Nathan E
AU  - Simmons NE
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
FAU - Evans, Linton T
AU  - Evans LT
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
FAU - Williams, Benjamin B
AU  - Williams BB
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
FAU - Gladstone, David J
AU  - Gladstone DJ
AD  - Dartmouth Cancer Center, One Medical Center Drive, Lebanon, NH 03756, USA.
FAU - Roberts, David W
AU  - Roberts DW
AD  - Dartmouth Cancer Center, One Medical Center Drive, Lebanon, NH 03756, USA.
FAU - Buckey, Jay C Jr
AU  - Buckey JC Jr
AD  - Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, 
      USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT01850563
GR  - P30 CA023108/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221028
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Humans
MH  - *Radiosurgery/adverse effects
MH  - *Brain Neoplasms/radiotherapy/secondary
MH  - Cranial Irradiation
MH  - Quality of Life
MH  - *Hyperbaric Oxygenation
MH  - Treatment Outcome
MH  - Retrospective Studies
MH  - *Radiation Injuries/etiology
MH  - Oxygen
PMC - PMC10827304
MID - NIHMS1958255
OTO - NOTNLM
OT  - Brain metastases
OT  - Hyperbaric oxygen
OT  - Radiation sensitizer
OT  - Stereotactic radiosurgery
COIS- Conflict of Interest None declared.
EDAT- 2022/11/22 06:00
MHDA- 2022/12/21 06:00
PMCR- 2024/01/30
CRDT- 2022/11/21 01:20
PHST- 2021/07/06 00:00 [received]
PHST- 2022/09/30 00:00 [revised]
PHST- 2022/10/21 00:00 [accepted]
PHST- 2022/11/22 06:00 [pubmed]
PHST- 2022/12/21 06:00 [medline]
PHST- 2022/11/21 01:20 [entrez]
PHST- 2024/01/30 00:00 [pmc-release]
AID - S0167-8140(22)04520-0 [pii]
AID - 10.1016/j.radonc.2022.10.024 [doi]
PST - ppublish
SO  - Radiother Oncol. 2022 Dec;177:179-184. doi: 10.1016/j.radonc.2022.10.024. Epub 
      2022 Oct 28.