Thursday, June 28

HYPERBARIC MEDICINE AND CANCER PLENARY             MECHANISMS OF HBO PLENARY



HYPERBARIC MEDICINE AND CANCER PLENARY
8:30 AM - 10:00 AM

0830-0915
John Feldmeier, DO
"Hyperbaric oxygen and cancer treatment with emphasis on its potential role combined with ketogenic diet and chemotherapy.

Feldmeier Pic OfficialAt the same time, other researchers have advocated hyperbaric oxygen as a primary treatment for malignant conditions, though the support is limited here. A number of studies done in the late 1950s through the 1970s even on review many years later firmly establish simultaneous hyperbaric oxygen as a radiosensitizer. There are reasons to believe that sequential hyperbaric oxygen followed immediately by can enhance cancer cell kill. The pioneering work by several Japanese authors have reported encouraging results in applying this combined treatment in high-grade brain tumors. More recently, a similar study supported in part by the Baromedical Research Foundation has shown the feasibility of applying these principles to head and neck cancers receiving both chemotherapy and radiation therapy with impressive results and no unexpected toxicities.
     There is a strong rationale and a bit of research that also suggest that chemotherapy’s antitumor effects can be enhanced by hyperbaric oxygen as well. Certainly, the logistics of delivering chemotherapy in the hyperbaric chamber are much easier than delivering radiation with HBO2.

     In this session, Dr. John Feldmeier will introduce an overview of the above issues. These will include a discussion of the Warburg effect and its implications for combined HBO2 and chemotherapy and HBO2 combined with the ketogenic diet.  A brief update will be presented on the status of HBO2 alone and how it effects malignant growth. Other mechanisms by which chemotherapy delivery and tumoricidal effects can likely be enhanced will be considered. 
     Mr. Richard Clarke will follow with a lecture updating the experience in a multi-center trial using sequential HBO2 and radiation with chemotherapy in advanced head and neck cancer patients.

0915-1000
Dick Clarke, CHT
"Hyperbaric Oxygen Radiation Sensitization of Squamous Cell Carcinomas of the Oropharynx"

Clarke IMG 1761 2This 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 well as 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.

 


MECHANISMS OF HBO PLENARY
4:00 PM - 5:00 PM
 

1600-1700
Stephen Thom, MD
"Hyperbaric Oxygen Therapy Cell Signaling & Mechanisms of Action"

thom


This lecture will summarize current knowledge on mechanisms of action for hyperbaric oxygen (HBO2) therapy. Information will include findings from peer-reviewed publications involving both animal and human studies. It will emphasize data from human investigations, with a focus on those actions most relevant to clinical HBO2 indications.