No evidence that hyperbaric oxygen influences cognitive disorders after irradiation of the brain

Clinical Bottom Line:

  1. Very small sample sizes with low power

  2.   No clear clinical implications

Citation:
Hulshof M, Stark N, Van der Kleij A, Sminia P, Smeding M, Gonzalez D. Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain. Strahlentherapie und Onkol 2001;177:192-8
Lead author's name and fax: m.c.hulshof@amc.uva.nl

Three-part Clinical Question: For patients with cognitive deficit following brain irradiation, dose the application of HBOT result in any improvement in function?
Search Terms: Cognitive disorders, Brain irradiation, Late radiation effects

The Study: Single-blinded randomised controlled trial without intention-to-treat.

The Study Patients: Adult patients with cognitive impairment at least 1.5 years after radiation

Control group (n= 3) Nil specific treatment

Experimental group (n=4) 30 hyperbaric treatments at 3ATA for 115 minutes

The Evidence:

 

Non-Event Outcomes

Time to outcome/s

Control group

HBOT group

P-value

31 neuropsychological tests

Mean difference only indicated for one

directly after HBO

not given

not given

0.016

Comments:
1.The one test outcome that significantly improved was a self-assesment test, and could have been influenced by not being blinded
2. Multiple comparisons in small sample size means high probability that this finding could be due to chance
3. Differences between control group and experimental group in tumour type, localization and radiation field

Appraised by: Annelies van der Hulst, Hyperbaric Unit, Prince of Wales Hospital, Randwick NSW.; Tuesday 16th August 2005
Email: m.bennett@unsw.edu.au

Kill or Update By: 16th of August 2007