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Journal of Neuro-Oncology

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01-01-2019 | Clinical Study

Use of hyperbaric oxygen therapy in pediatric neuro-oncology: a single institutional experience

Authors: Yasmin Aghajan, Ian Grover, Hamza Gorsi, Mark Tumblin, John Ross Crawford

Published in: Journal of Neuro-Oncology | Issue 1/2019

Abstract

Introduction

Hyperbaric oxygen therapy (HBOT) has been utilized as adjunctive treatment of CNS tumors and for radiation necrosis (RN) with reported success. The safety and efficacy in pediatric patients is less understood.

Methods

Seven patients (ages 10–23 years, six females) were treated with HBOT (3–60 sessions) for either RN (n = 5) or tumor-associated edema (n = 2). Tumor diagnosis included low-grade glioma (n = 4, two with neurofibromatosis type 1), meningioma (n = 1), medulloblastoma (n = 1) and secondary high grade glioma (n = 1). Prior therapies included: surgery (n = 4), chemotherapy (n = 4) and radiation (N = 5: four focal, one craniospinal). Three underwent biopsy: one confirming RN, one high-grade glioma, and one low-grade glioma. Patients were assessed for clinical and radiographic changes post HBOT.

Results

Median time to clinical and radiographic presentation was 8.5 months (range 6 months–11 years) in those who had prior radiation. Clinical improvement after HBOT (median: 40 sessions) was observed in four of seven patients. Symptoms were stable in two and worsened in one patient. Radiographic improvement was seen in four patients; three had radiographic disease progression. In the subgroup treated for presumed and biopsy-confirmed RN (n = 5), four of five (80%) had clinical and radiographic improvement. There were no long-term adverse events due to HBOT.

Conclusions

HBOT is safe and well-tolerated in pediatric and young adult patients with CNS tumors. Clinical and radiographic improvements were observed in over half of patients. Clinical trials are needed to establish safety and efficacy of HBOT as adjunct therapy in pediatric CNS tumors.

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Title: Use of hyperbaric oxygen therapy in pediatric neuro-oncology: a single institutional experience
Authors: Yasmin Aghajan
Ian Grover
Hamza Gorsi
Mark Tumblin
John Ross Crawford
Publication date: 01-01-2019
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 1/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-03021-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Use of hyperbaric oxygen therapy in pediatric neuro-oncology: a single institutional experience

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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