A randomised pilot trial in 20 patients with locally advanced head-and-neck cancer compared standard concurrent chemoradiotherapy with added hydrogen inhalation and explored pre-post metabolomics. Moderate toxicities and treatment delays were numerically fewer with hydrogen, but differences were not significant and only 19 participants were evaluable.
Key findings
- The standard arm showed changes in arginine, glutathione and purine pathways with candidates including ornithine, uric acid and tetrahydrodeoxycorticosterone. The hydrogen arm had limited pathway mapping and some single-feature signals. The smaller uric-acid reduction was not significant, as were numerical clinical differences.
Why this matters globally
The pilot helps design studies of toxicity-mitigation biology and produces biomarker candidates for confirmatory trials, but provides no basis for changing standard care.
Thai researcher contribution
The Chiang Mai-NSTDA team linked a pilot clinical trial with metabolomics to explore patient outcomes and mechanism in Thai cancer care.
Limitations to consider
Only 20 patients were enrolled and 19 analysed, leaving very low power. The trial was not designed for survival or tumour control. Untargeted metabolomics involves multiple testing and false-positive risk; some pathways had sparse signals, and there was no targeted or external validation.