[Therapeutic Approaches to Radiation Cystitis]

Radiation-induced cystitis is a common complication following radiotherapy for pelvic malignancies such as prostate, bladder, and cervical cancer. Acute toxicity occurs in up to 50% of patients, while late toxicity is observed in 5-11%. Triggering factors include radiation dose, treatment planning, and patient-related factors such as radiosensitivity, comorbidities, and smoking. The condition leads to inflammatory and fibrotic changes in the bladder mucosa, resulting in symptoms such as dysuria and haematuria. This review provides a comprehensive overview of available therapeutic options for the management of radiation-induced cystitis. Conservative, pharmacological, interventional, and surgical approaches are described and assessed with respect to their efficacy, safety, and clinical indications. In cases of acute toxicity, treatment is primarily conservative and symptom-oriented. Intravesical therapies, such as hyaluronic acid and alum solution, demonstrate moderate response rates in clinical studies. Hyperbaric oxygen therapy has shown promising results, achieving partial remission in 64-100% of cases and demonstrating a favourable safety profile. More invasive interventions, including embolisation and cystectomy, are considered treatments of last resort due to their substantial perioperative risks. The management of radiation-induced cystitis requires a multimodal treatment strategy. Standardisation of therapeutic algorithms may contribute to improved clinical outcomes and optimised patient care.