Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): long-term follow-up of a randomised...

Area of Science:

• Oncology
• Urology
• Hyperbaric Medicine

Background:

• Chronic radiation-induced cystitis is a debilitating complication following pelvic radiotherapy.
• Symptoms significantly impact patient quality of life, with limited data on long-term treatment efficacy.
• Hyperbaric oxygen (HBO2) is a known symptomatic treatment, but its sustained benefits require further investigation.

Purpose of the Study:

• To evaluate the long-term (5-year) efficacy of hyperbaric oxygen (HBO2) in treating chronic radiation-induced cystitis.
• To assess the sustained symptom relief provided by HBO2 therapy in patients previously treated with pelvic radiotherapy.
• To report on the secondary outcomes of the RICH-ART trial regarding long-term symptom management.

Main Methods:

• A multicentre, open-label, phase 2-3 trial (RICH-ART) involving patients with chronic radiation-induced cystitis.
• Randomization to HBO2 therapy (30-40 sessions) or standard care, with control group patients later offered HBO2.
• Long-term symptom relief measured by the Expanded Prostate Cancer Index Composite (EPIC) urinary total score up to 5 years post-treatment.

Main Results:

• Mean EPIC urinary total score improved significantly from baseline and remained stable at 5 years (19.1-point increase).
• 68.6% of patients were responders, maintaining a mean increase of 22.9 points at 5 years.
• Non-responders showed no early benefit, and 12.8% required additional HBO2 for recurring symptoms.

Conclusions:

• HBO2 therapy demonstrates sustained efficacy in alleviating chronic radiation-induced cystitis symptoms over 5 years.
• The findings support HBO2 as a valuable therapeutic option for managing long-term radiation-induced adverse effects.
• Further research is recommended to optimize treatment protocols and identify predictive biomarkers.