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Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis
Open accessAbstract
The aim of this study was to determine the efficacy of palliative oxygen for relief of dyspnoea in cancer patients. MEDLINE and EMBASE were searched for randomised controlled trials, comparing oxygen and medical air in cancer patients not qualifying for home oxygen therapy. Abstracts were reviewed and studies were selected using Cochrane methodology. The included studies provided oxygen at rest or during a 6-min walk. The primary outcome was dyspnoea. Standardised mean differences (SMDs) were used to combine scores. Five studies were identified; one was excluded from meta-analysis due to data presentation. Individual patient data were obtained from the authors of the three of the four remaining studies (one each from England, Australia, and the United States). A total of 134 patients were included in the meta-analysis. Oxygen failed to improve dyspnoea in mildly- or non-hypoxaemic cancer patients (SMD=-0.09, 95% confidence interval -0.22 to 0.04; P=0.16). Results were stable to a sensitivity analysis, excluding studies requiring the use of imputed quantities. In this small meta-analysis, oxygen did not provide symptomatic benefit for cancer patients with refractory dyspnoea, who would not normally qualify for home oxygen therapy. Further study of the use of oxygen in this population is warranted given its widespread use.
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“Oxygen therapy, although it reverses hypoxaemia, does not improve breathlessness in patients with cancer, and the marginal benefit seen in a meta-analysis of COPD patients is of dubious clinical significance.”
From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [16]
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Parshall, M. B., Schwartzstein, R. M., Adams, L., Banzett, R. B., Manning, H. L., Bourbeau, J., Calverley, P. M., Gift, A. G., Harver, A., Lareau, S. C., et al. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201111-2042st · Cited by 1,844
BTS guideline for oxygen use in adults in healthcare and emergency settings
O’Driscoll, B. R., Howard, L., Earis, J. E., & Mak, V. H. F. (2017) · Thorax · doi:10.1136/thoraxjnl-2016-209729 · Cited by 710
Abernethy, A. P., McDonald, C. F., Frith, P. A., Clark, K., Herndon, J. E., Marcello, J. E., Young, I. H., Bull, J., Wilcock, A., Booth, S., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61115-4 · Cited by 494
Self-citationAhmed, I., Sutton, A. J., & Riley, R. D. (2012) · BMJ · doi:10.1136/bmj.d7762 · Cited by 404
British Thoracic Society guidelines for home oxygen use in adults: accredited by NICE
Hardinge, M., Annandale, J., Bourne, S. C., Cooper, B. G., Evans, A., Freeman, D., Green, A., Hippolyte, S., Knowles, V., MacNee, W., et al. (2015) · Thorax · doi:10.1136/thoraxjnl-2015-206865 · Cited by 326
Metadata
- Authors
- Uronis, H. E., Currow, D. C., McCrory, D. C., Samsa, G. P., & Abernethy, A. P.
- Affiliations
- Duke Medical Center (US)
- Flinders University (AU)
- Duke University (US)
- Corresponding author
- Abernethy, A P
- Venue
- British Journal of Cancer
- Published
- 2008-01
- Volume
- 98
- Issue
- 2
- Pages
- 294-299
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC2361446
- OpenAlex
- W2070591275
- Cited by
- 165
- References
- 40
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 8 · 2022: 8 · 2021: 10 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 9 · 2016: 7 · 2015: 19 · 2014: 13 · 2013: 12 · 2012: 18
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Flinders Academic Commons (Flinders University) (submittedVersion)
- DukeSpace (Duke University) (submittedVersion, cc-by-nc-nd)
- Funders
- Agency for Healthcare Research and Quality (T32HS000079)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- dyspnea, cancer, medical air, home oxygen therapy, symptom relief, 6-minute walk test
- MeSH terms
- Aged, Algorithms, Hypoxia, Dyspnea, Female, Humans, Male, Neoplasms, Oxygen, Oxygen Inhalation Therapy, Palliative Care, Randomized Controlled Trials as Topic, Treatment Outcome
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