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 cisplatin 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.
- Describe the therapeutic rational to study this particular tumor type/grade.
- Summarize the evolution from concurrent to sequential hyperbaric oxygen-radiation therapy.
- Discuss results in the context of patient safety and operational feasibility.
- Non-Member: $22.50
- Regular UHMS Member: $17.50
- Associate UHMS Member: $12.50
Estimated time to complete this activity: 45 minutes
Accreditation Statement: The Undersea and Hyperbaric Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physician.
Disclosure: All faculty members and planners participating in continuing medical education activities sponsored by UHMS are expected to disclose to the participants any relevant financial relationships with commercial interests. Full disclosure of faculty and planner relevant financial relationships will be made at the activity.
Designation Statements (CME/CEU Approvals):
Physician CME: The Undersea & Hyperbaric Medical Society designates this enduring material for a maximum of .75 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
MOC ABPM: The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.
Nursing/RRT: This enduring material is approved for 1.00 contact hours provided by Florida Board of Registered Nursing/RRT Provider #50-10881.
For NBDHMT: This enduring material is approved for .75 Category A credit hours by National Board of Diving and Hyperbaric Medical Technology, 9 Medical Park, Suite 330, Columbia, South Carolina 29203
Termination Date: February 20, 2022
Disclaimer: The information provided by this CME material is for Continuing Medical Education purposes only. The lecture content, statements or opinions expressed however, do not necessarily represent those of the Undersea and Hyperbaric Medical Society (UHMS), its affiliates or its employees.
Goal: For over 40 years the UHMS has been the primary source of information for hyperbaric medicine and physiology worldwide. This enduring material has as its goal to address identified professional practice gaps and provide a quality CME opportunity which will improve scientific knowledge and skills for hyperbaric and wound care: physicians, nurses and technicians, and other clinicians and personnel whose practice includes hyperbaric medicine and wound care.
Target Audience – physicians, nurses, CHT’s or anyone with an interest in research and hyperbaric oxygen therapy.
All individuals in control of content for this educational activity with their relevant financial relationship disclosed are listed below. ACCME defines a relevant financial relationship “as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.” An individual who refuses to disclose relevant financial relationships will be disqualified from being a planning committee member, a teacher, or an author of CME, and cannot have control of, or responsibility for, the development, management, presentation or evaluation of the CME activity.
|Name of Individual||Individuals Role in Activity||Name of Commercial Interest (If Applicable)||Nature of Relationship|
|Dick Clarke, CHT
|Stacy Harmon, BS
|Tom Bozzuto, DO
|Owen J. O’Neill, MD
|Ben Slade, MD
|Dag Shapshak, MD
|J. Nicholas Vandemoer, MD
About the presenter:
Dick’s accumulated experience within the combined disciplines of undersea and hyperbaric medicine extends over 50 years. Following service in the Royal Navy throughout the decade of the 1960’s he spent two years as program director at the International Underwater Explorers Society, in the Bahamas. Dick then joined the seabed living program ‘Hydrolab’, operating and saturating in underwater habitats in the subtropics and beneath arctic ice, as a member of the National Oceanographic and Atmospheric Administration aquanaut corps. From 1976 to 1985 he was employed by Oceaneering International as an oilfield saturation diving superintendent. During this period, he was a member of the group that developed the diver medic training program and its subsequent board certification process. Dick served as a faculty member for NOAA’s diving medical officer training course for 25 years. Since 1985 Dick has centered his hyperbaric and diving medicine operational support, education and research programs at Palmetto Health Richland Hospital/University of South Carolina School of Medicine. He founded the non-profit Baromedical Research Foundation in 1987. Initially a basic science laboratory, it evolved to become a centerpiece for an international clinical trials consortium. One of the Foundations’ initiatives became the first randomized, controlled double-blind long-term follow-up trial to prove therapeutic efficacy of hyperbaric medicine in deficient wound healing states. More recent work has addressed the potential radiation sensitization effect of hyperbaric oxygen on newly diagnosed squamous cell carcinomas. Dick was instrumental in the development of the Hyperbaric Technology (CHT) program and continues to serve as president of its certification body, the National Board of Diving & Hyperbaric Medical Technology. He has written numerous peer reviewed medical and technical papers and authored chapters in several undersea medicine and hyperbaric oxygen therapy textbooks.
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