No evidence for benefit of hyperbaric oxygen therapy in brain radionecrosis (early interim report)

5 of 7 patients have suffered adverse events

Citation/s:
Gesell LB, Warnick RE, Brenerman JC, Vogt CJ, Lindsell CJ. A randomized, controlled trial of hyperbaric oxygen therapy for brain radionecrosis. Undersea and Hyperbaric Medicine, 2005. 32(4): 235-236

Three-part Clinical Question: For patients with brain radionecrosis, does hyperbaric oxygen therapy improve functional outcome?
Search Terms: Radiation injury, Brain tumour, Neuropsychiatric testing

The Study:
Non-blinded randomised controlled trial intention-to-treat unknown.
The Study Patients: PET-scan confirmed brain radionecrosis on steroids at a dose that cannot be tapered down
Control group (N = ?): Steroid treatment, dose adjusted to oedema volume and Karnofsky score, for 3 months
Experimental group (N = ?): As above, plus 60 treatments of 100% oxygen breathing at an unspecified pressure on an ‘accelerated air break’ protocol

The Evidence:

Outcome

Time to Outcome

Total

Adverse events

unknown

5 of 7 patients enrolled

 

 

 

Non-Event Outcomes

Time to outcome/s

Quality of Life

4 months

Neuropsychologoical testing

4 months

Neuroimaging

4 months

Comments:
1. Abstract only
2. 7 patients enrolled, allocation unknown
3. No discussion of randomization procedure, blinding, or allocation concealment
4. Severe nature of disease and co-morbidities threaten to disrupt this trial

Appraised by: A/Prof Mike Bennett, Dr Sean Hopson

Department of Diving and Hyperbaric Medicine Prince of Wales Hospital Sydney ; Friday, 22 September 2006
Email: m.bennett@unsw.edu.au


Kill or Update By: Oct 2007