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A trial looking at Hyperbaric Oxygen (HBO) Treatment for people who have long term side effects following radiotherapy for pelvic cancer
Source of recordUK Trials
ISRCTNISRCTN86894066
Date ISRCTN assigned31/03/2008
Local reference number(s)N/A
Public titleA trial looking at Hyperbaric Oxygen (HBO) Treatment for people who have long term side effects following radiotherapy for pelvic cancer
Scientific titleRandomised double-blind phase III trial of hyperbaric oxygen therapy in patients suffering long-term adverse effects of radiotherapy for pelvic cancer
AcronymHOT II
Disease/condition/study domainPelvic cancer
Study hypothesisCurative radiotherapy is prescribed to an increasing number (12,000 per year) of UK patients with pelvic malignancies, and more individuals are living with a significant legacy of treatment related morbidity. The UK prevalence of radiation-induced bowel morbidity causing significant impairment of physical functioning is unknown, but the US estimate is one million individuals.

The primary goal of this trial is to test the clinical benefits of high pressure oxygen therapy in restoring normal bowel function to patients suffering chronic radiation-induced gastrointestinal complications following curative radiotherapy for pelvic cancers.
Design/methodologyMulticentre, double-blind randomised controlled phase III trial.
Research ethics reviewEthics approval to be obtained from the Central Office for Research Ethics Committees (COREC) in May 2008.
Countries of trialUnited Kingdom
Participants - inclusion criteria1. Age over 18 years, either sex
2. Past history of a malignant pelvic neoplasm (T1-3 N0-1 M0)
3. Minimum 12 months follow-up post-radiotherapy
4. No evidence of cancer recurrence
5. Grade 1 - 3 gastrointestinal morbidity (late effects in normal tissues subjective, objective, management and analytic scales [LENT SOMA]) not present before radiotherapy
6. Physical and psychological fitness for hyperbaric therapy
7. Written informed consent and available for follow-up
Participants - exclusion criteria1. Prior hyperbaric oxygen therapy
2. Claustrophobia
3. Epilepsy
4. Chronic obstructive airways disease
5. Bullous lung disease
6. Acute or chronic pulmonary infection
7. Uncontrolled asthma
8. Untreated pneumothorax
9. Previous middle/inner ear operations (except grommets and similar procedures) and/or irremediable inability to equalise middle ear pressure
10. Contra-indication or other inability to undergo magnetic resonance imaging, if required to rule out malignancy
Patient information materialNot available in web format, please use the contact details below to request a patient information sheet
Anticipated start date01/08/2008
Anticipated end date01/08/2011
Status of trialOngoing
Target number of participants75
InterventionsTreatment group:
Patients are compressed to 2.4 atmospheres (ATA) in a hyperbaric chamber and breathe 100% oxygen at pressure following a RN66 (Royal Navy) protocol. The total time at 2.4 ATA is 90 minutes. Each participant receives 40 pressure exposures (five days per week for eight weeks).

Control group:
Patients are compressed to 1.3 ATA in a hyperbaric chamber and breathe 21% oxygen (air). The total time at 1.3 ATA is 90 minutes. Each participant receives 40 pressure exposures (five days per week for eight weeks).

Total follow up for both treatment arms is 12 months.
Primary outcome measure(s)Patient self assessment using the modified inflammatory bowel disease questionnaire (IBDQ), completed by the patient before treatment, 3, 6, 9 and 12 months post-treatment.
Secondary outcome measure(s)1. Physician assessment of bowel dysfunction using LENT SOMA scales of radiation injury, carried out before treatment, within two weeks of treatment finishing and at 12 months post-treatment
2. Patient self-assessments using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for Cancer patients (EORTC QLQ-C30) and defaecation problem subscale of the colorectal cancer-specific quality of life questionnaire module (QLQ-CR38), carried out before treatment, 3, 6, 9 and 12 months post-treatment
3. Photographic images of rectal mucosa taken via flexible sigmoidoscopy, taken before treatment, within 2 weeks of treatment finishing and at 12 months post-treatment
Sources of fundingCancer Research UK (CRUK) (UK) (ref: C181/A9694)
Sponsor nameInstitute of Cancer Research (UK)
Sponsor detailsDowns Road
Sutton, Surrey
United Kingdom
SM2 5PT
Sponsor websitehttp://www.icr.ac.uk/
Contact nameProf John Yarnold
Contact detailsThe Royal Marsden Hospital
Downs Road
Sutton, Surrey
United Kingdom
SM2 5PT
Contact emailJohn.Yarnold@icr.ac.uk
More informationFor more up-to-date information please go to the ISRCTN link below.
Link to record in ISRCTN RegisterISRCTN86894066
Date last extracted from ISRCTN register17/04/2008
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