by E.L. Meier, D.R.
Mink van der Molen, C.A. Lansdorp, M.C.T. Batenburg, F. van der Leij, H.M.
Verkooijen, O. Boonstra, S. Hummelink, D.J.O. Ulrich
The Breast: Published: December 22, 2022
Purpose
This systematic
review aims to provide an overview of the literature on the effect of
hyperbaric oxygen therapy (HBOT) on symptoms of local late radiation toxicity
(LRT) in patients treated for breast cancer.
Methods
A systematic search
was performed in September 2021. All studies with a sample size of ≥10 patients
reporting the effect of HBOT for symptoms of LRT after radiotherapy of the
breast and/or chest wall were included. The ROBINS-I tool was used for critical
appraisal of methodological quality. The toxicity outcomes pain, fibrosis,
lymphedema, necrosis/skin problems, arm and shoulder mobility, and breast and
arm symptoms were evaluated.
Results
Nine studies
concerning a total of 1308 patients were included in this review. Except for
one study, sample sizes were small. Most studies had inadequate methodology
with a substantial risk of bias. Post-HBOT, a significant reduction of pain was
observed in 4/5 studies, of fibrosis in 1/2 studies, and of lymphedema of the
breast and/or arm in 4/7 studies. Skin problems of the breast were
significantly reduced in 1/2 studies, arm- and shoulder mobility significantly
improved in 2/2 studies, and breast- and arm symptoms were significantly
reduced in one study.
Conclusion
This systematic
review indicates that HBOT might be useful for reducing symptoms of LRT in
breast cancer patients, however evidence is limited. A randomized controlled
trial in a larger cohort of patients including a combination of patient- and
clinician-reported outcome measures would be valuable to assess the effect of
HBOT on symptoms of LRT.
