Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up

Area of Science:

• Oncology
• Urology
• Hyperbaric Medicine

Background:

• Pelvic irradiation can cause bladder complications, including radiation-induced hemorrhagic cystitis (RIHC), affecting up to 12% of patients.
• Hyperbaric oxygen therapy (HBOT) is a recognized treatment option for managing RIHC.
• Identifying predictors of successful HBOT outcomes is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in treating radiation-induced hemorrhagic cystitis (RIHC).
• To identify predictive factors associated with successful outcomes in patients receiving HBOT for RIHC.

Main Methods:

• A retrospective review of 105 patients diagnosed with RIHC and treated with HBOT between 2007 and 2016.
• Patients received 100% oxygen at 2.4 atm for 80 minutes in a multiplace hyperbaric chamber.
• Symptom severity (dysuria, urinary frequency, hematuria) was assessed via questionnaire pre-HBOT and post-follow-up.

Main Results:

• A high success rate of 92.4% in controlling hematuria was observed after a median of 40 HBOT sessions.
• Long-term follow-up (median 63 months) showed a 24.7% recurrence rate of hematuria.
• Significantly lower scores for dysuria, urinary frequency, and hematuria were noted post-treatment (P<.05).
• Earlier initiation of HBOT after initial hematuria correlated with better response rates and reduced recurrence (P<.05).

Conclusions:

• HBOT demonstrates safety and long-term benefits for managing RIHC and associated distressing bladder symptoms.
• Successful HBOT outcomes are linked to earlier treatment initiation.
• Treatment with HBOT is expected to improve the quality of life for patients experiencing radiation-induced bladder complications.