[abstract] CHEMOTHERAPY AND HYPERBARIC OXYGEN: PITFALLS AND PROMISE

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[abstract] CHEMOTHERAPY AND HYPERBARIC OXYGEN: PITFALLS AND PROMISE

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Title: [abstract] CHEMOTHERAPY AND HYPERBARIC OXYGEN: PITFALLS AND PROMISE
Author: Feldmeier, J
Abstract: BACKGROUND: Patients with cancer in 2009 often survive for years without being cured. They often have had multi-modality therapies including surgery, radiation and chemotherapy. Such patients may experience delayed complications from radiation and are properly patients in whom hyperbaric oxygen would be indicated. A dilemma occurs when these patients are simultaneously being treated with systemic chemotherapy agents. MATERIALS AND METHODS: A small body of literature exists reporting experience with concurrent hyperbaric oxygen and chemotherapy. No systematic reviews have been accomplished. Practitioners find themselves having to make decisions in regard to concurrent therapy in this information void. For this presentation, putative interactions between chemotherapy and hyperbaric oxygen are explored based on the known mechanistic and pharmacologic properties of HBO2 and these anti-cancer agents. RESULTS: It is helpful to divide the systemic chemotherapeutic agents into categories by their mechanisms of action. Several categories of these agents exist. In addition to the older cytotoxic agents, new categories of drugs including anti-angiogenic agents and targeted therapies are now applied with increasing frequency. Special precaution must be exerted when hyperbaric oxygen is given with the intent of enhancing wound healing and patients are receiving cancer therapies which target angiogenesis of growth factors such as VEGF or EGFR. Special care must also be taken when complication profiles of the utilized drug and HBO2 overlap or demonstrate possible harmful synergy. Some have suggested that HBO2 may ameliorate the harmful effects of chemotherapy; however, experience is limited and mechanisms are uncertain. Some agents may have both therapeutic and harmful effects enhanced by HBO2. CONCLUSIONS: Although clinical guidance for the concurrent use of hyperbaric oxygen and systemic agents used in cancer care is lacking, certain common sense recommendations are possible based on known mechanisms. Certain agents are at least relatively contraindicated. In others synergy may exist. Finally, claims that HBO2 has lessened chemotherapy toxicity should be studied in a systematic fashion.
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting, Las Vegas, Nevada, USA. (http://www.uhms.org)
URI: http://archive.rubicon-foundation.org/9124
Date: 2009

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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