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Systemic review of hyperbaric oxygen therapy for radiation-induced skin necrosis

Study finds that hyperbaric oxygen therapy (HBOT) reduced the symptom burden of patients receiving radiation therapy.

Study finds that hyperbaric oxygen therapy (HBOT) reduced the symptom burden of patients receiving radiation therapy

With over half a million Americans receiving radiation therapy for cancer each year, damage to skin tissues within the radiation field are a common occurrence with longer term serious sequelae, such as reduced vascularity, tissue necrosis and fibrosis, and skin atrophy, which is found in between 5% and 15% of patients.

Hyperbaric oxygen therapy (HBOT), where the patient breathes 100% oxygen at pressures greater than one atmosphere in a hermetic chamber, is frequently employed as adjuvant management; the putative mechanisms of action include promoting angiogenesis and augmenting development of collagen. This study reviewed the evidence for effectiveness of this modality.

Using the preferred reporting items for systematic reviews and meta-analysis guidelines, eight papers met the inclusion

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Study finds that hyperbaric oxygen therapy (HBOT) reduced the symptom burden of patients receiving radiation therapy


A hyperbaric chamber in a hospital. Picture: Science Photo Library

With over half a million Americans receiving radiation therapy for cancer each year, damage to skin tissues within the radiation field are a common occurrence with longer term serious sequelae, such as reduced vascularity, tissue necrosis and fibrosis, and skin atrophy, which is found in between 5% and 15% of patients.

Hyperbaric oxygen therapy (HBOT), where the patient breathes 100% oxygen at pressures greater than one atmosphere in a hermetic chamber, is frequently employed as adjuvant management; the putative mechanisms of action include promoting angiogenesis and augmenting development of collagen. This study reviewed the evidence for effectiveness of this modality.

Using the preferred reporting items for systematic reviews and meta-analysis guidelines, eight papers met the inclusion criteria for investigation and comprised a range of study designs: five case series, two case reports and one observational cohort study. Data from more than 700 patients who received HBOT for radiation-induced skin necrosis was analysed.

The findings suggested that HBOT reduced the symptom burden of patients and improved complete wound healing; however, the authors acknowledged that the level of evidence and quality of papers is limited and so could not necessarily inform evidence-based practice guidelines. The pooled data from the studies suggested a complete resolution of pain and wound healing symptoms in almost one third of the participants and complete wound healing in almost four-fifths.


Borab Z, Mirmanesh M D, Gantz M et al (2017) Systematic review of hyperbaric oxygen therapy for the treatment of radiation induced skin necrosis. Journal of Plastic, Reconstructive and Aesthetic Surgery doi: 10.1016/j.bjps.2016.11.024.

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