Thursday, June 28
John Feldmeier, DO
"The role of hyperbaric medicine in cancer therapy"
Dick Clarke, CHT
"Hyperbaric Oxygen Radiation Sensitization of Squamous Cell Carcinomas of the Oropharynx"
This presentation summarizes the first study of hyperbaric oxygen chemo-radiation sensitization for locally advanced squamous cell carcinomas of the oropharynx. It took the form of a Stage I dose escalation trial, designed to determine safety, feasibility and tolerability when hyperbaric oxygen was added to standard care, namely intensity modulated radiation therapy and cisplatinum chemotherapy. The presentation will describe the biological plausibility and physiologic basis for pre-radiation hyperbaric hyperoxia, and the rationale for selection of this tumor type and tumor grade. The hyperbaric dosing regimen, one based upon previous human tumor oxygen response curves, is discussed, and the critical time window for radiation therapy “beam on” from exiting the chamber discussed. Evolution from earlier sensitization studies that employed concurrent hyperbaric oxygen-radiation therapy to the modern sequential approach are described, as will its inherent advantages. A staging protocol employed to titrate hyperbaric dose against possible acute toxicities is described. Acute toxicities and five-year follow-up results are presented, as is a Stage III study design, in the form of a randomized, sham controlled clinical double-blind trial.
Stephen Thom, MD
"Cell signaling and mechanisms of action: how does hyperbaric oxygen really work?"