Effects of Ozone Treatment on Health-Related Quality of Life and Toxicity Induced by Radiotherapy and Chemotherapy in Symptomatic Cancer Survivors

Bernardino Clavo; Angeles Cánovas-Molina; Yolanda Ramallo-Fariña; Mario Federico; Delvys Rodríguez-Abreu; Saray Galván; Ivone Ribeiro; Susana C Marques da Silva; Minerva Navarro; Damián González-Beltrán; Juan A Díaz-Garrido; Sara Cazorla-Rivero; Francisco Rodríguez-Esparragón; Pedro Serrano-Aguilar

doi:10.3390/ijerph20021479

Effects of Ozone Treatment on Health-Related Quality of Life and Toxicity Induced by Radiotherapy and Chemotherapy in Symptomatic Cancer Survivors

Int J Environ Res Public Health. 2023 Jan 13;20(2):1479. doi: 10.3390/ijerph20021479.

Authors

Bernardino Clavo^{1

2

3

4

5

6

7

8}, Angeles Cánovas-Molina^{1

2

4}, Yolanda Ramallo-Fariña^{4

9

10

11}, Mario Federico³, Delvys Rodríguez-Abreu¹², Saray Galván¹³, Ivone Ribeiro³, Susana C Marques da Silva^{1

2}, Minerva Navarro², Damián González-Beltrán¹, Juan A Díaz-Garrido¹⁴, Sara Cazorla-Rivero^{1

15}, Francisco Rodríguez-Esparragón^{1

4

6

7}, Pedro Serrano-Aguilar^{9

10

11}

Affiliations

¹ Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
² Chronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas de Gran Canaria, Spain.
³ Radiation Oncology Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
⁴ Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain.
⁵ Universitary Institute for Research in Biomedicine and Health (iUIBS), Molecular and Translational Pharmacology Group, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
⁶ Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38296 La Laguna, Spain.
⁷ CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain.
⁸ Spanish Group of Clinical Research in Radiation Oncology (GICOR), 28290 Madrid, Spain.
⁹ Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029 Madrid, Spain.
¹⁰ Servicio de Evaluación y Planificación del Servicio Canario de Salud (SESCS), 38109 Santa Cruz de Tenerife, Spain.
¹¹ Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, 38296 La Laguna, Spain.
¹² Medical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
¹³ Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
¹⁴ Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
¹⁵ Universidad de La Laguna, 38296 La Laguna, Spain.

Abstract

(1) Background: The continuous improvement in cancer treatment has led to improvement in patients’ survival and a subsequent increase in the number of cancer survivors living with adverse side effects of cancer treatments, sometimes with a high and adverse impact on their health-related quality of life (HRQOL). Side effects of cancer treatments are frequently associated with chronic status of oxidative stress, inflammation, and/or ischemia. The potential for ozone treatment to modulate those processes and improve some of those adverse effects has previously been described. The aim of this study was to evaluate the effect of ozone treatment on the HRQOL and grade of toxicity in symptomatic cancer survivors. (2) Methods: Before and after ozone treatment, we assessed (i) the HRQOL (according to the EQ-5D-5L questionnaire) and (ii) the grade of toxicity (according to the Common Terminology Criteria for Adverse Events of the National Cancer Institute of EEUU (CTCAE v.5.0)) in 26 cancer survivors with chronic side effects of radiotherapy and chemotherapy. (3) Results: There was a significant (p < 0.001) improvement in the EQ-5D-5L index as per the self-reported outcome evaluation of patients’ health status. All the dimensions of the EQ-5D-5L questionnaire (mobility, self-care, activities, pain/discomfort, and anxiety/depression) and the self-evaluation of the health status using the visual analog scale were significantly improved (p < 0.05). The grade of toxicity was also significantly decreased (p < 0.001). (4) Conclusions: In cancer survivors with chronic side effects of cancer treatment, ozone treatment can improve the grade of toxicity and the HRQOL. These results merit additional research. Further studies are ongoing.

Keywords: anxiety and depression; cancer survivors; chemotherapy-induced neuropathy; chemotherapy-induced side effects; health-related quality of life; ozone therapy; pain; radiation-induced side effects.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cancer Survivors*
Cross-Sectional Studies
Health Status
Humans
Neoplasms*
Quality of Life
Surveys and Questionnaires

Grants and funding

This study was partially supported by a grant (PI 19/00458) from the Instituto de Salud Carlos III (Spanish Ministry of Science and Innovation, Madrid, Spain and European Regional Development Fund—ERDF); a grant (016/2019) from the Fundación DISA (Las Palmas, Spain); a grant (BF1-19-13) from the Fundación Española del Dolor (Spanish Pain Foundation, Madrid, Spain); a grant (ENF22/10) from the Fundación Canaria Instituto Investigación Sanitaria de Canarias (FIISC), Las Palmas, Spain; and a grant (CIGC2021) from the Cabildo de Gran Canaria, Las Palmas, Spain. During this work, S.C.R. was funded by a postdoctoral Grant Margarita Salas from Ministerio de Universidades, Fondos Next Generation EU, and Universidad de la Laguna (UNI/551/2021).