Hyperbaric oxygen therapy for radiation-induced cystitis and proctitis.

Area of Science:

• Oncology
• Radiation Oncology
• Hyperbaric Medicine

Background:

• Pelvic radiotherapy can cause radiation-induced hemorrhagic cystitis (HC) and proctitis.
• These conditions often present with refractory bleeding, significantly impacting patient quality of life.
• Limited treatment options exist for patients with bleeding unresponsive to conventional therapies.

Purpose of the Study:

• To retrospectively analyze the efficacy of hyperbaric oxygen therapy (HBOT) for treating hemorrhagic cystitis (HC) and proctitis.
• To evaluate HBOT's effectiveness in patients with radiation-induced gastrointestinal and genitourinary bleeding secondary to pelvic radiotherapy.
• To assess both short-term symptom improvement and long-term recurrence rates following HBOT.

Main Methods:

• Nineteen patients with refractory radiation-induced HC or proctitis received HBOT (100% oxygen at 2.0 ATA).
• Symptoms were assessed using the Late Effects of Normal Tissues-Subjective, Objective, Management, Analytic (LENT-SOMA) scale.
• Short-term efficacy was evaluated by LENT-SOMA score reduction, and long-term efficacy by recurrence of hematuria/hematochezia.

Main Results:

• All 15 evaluated patients showed reduced LENT-SOMA scores post-HBOT.
• Significant improvements were observed in both HC (mean score reduction 0.78 to 0.20) and proctitis (0.66 to 0.26).
• Complete hematuria resolution occurred in 81% of patients, with recurrence in 36% after a median of 10 months; proctitis resolution varied.

Conclusions:

• Hyperbaric oxygen therapy (HBOT) is a suitable treatment for radiation-induced HC and proctitis when less time-consuming therapies have failed.
• HBOT demonstrates efficacy in providing both short-term symptom relief and long-term control of bleeding.
• The therapy is associated with minimal side effects, making it a valuable option for managing radiation-induced pelvic complications.