Hyperbaric oxygen therapy for radiation induced hemorrhagic cystitis

Area of Science:

• Oncology
• Urology
• Hyperbaric Medicine

Background:

• Radiation therapy for pelvic malignancies can cause hemorrhagic cystitis, a debilitating complication.
• This condition arises from obliterative endarteritis, leading to tissue hypoxia and impaired healing.
• Hyperbaric oxygen therapy (HBOT) is known to enhance angiogenesis and tissue repair.

Purpose of the Study:

• To evaluate the efficacy and long-term outcomes of hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis.
• To assess HBOT as a treatment option for patients unresponsive to standard therapies.
• To describe the treatment protocol and patient follow-up in a cohort study.

Main Methods:

• Seventeen patients with hemorrhagic cystitis, unresponsive to standard treatments, received daily hyperbaric oxygen therapy.
• Treatment continued until hematuria resolved, with a mean of 14 sessions.
• Patient follow-up ranged from 9 to 60 months (mean 21 months).

Main Results:

• Complete resolution of hematuria occurred in 11 out of 17 patients (64.7%).
• Two patients experienced residual microscopic hematuria, and two had recurrence of gross hematuria.
• Early HBOT application correlated with faster resolution of hemorrhagic cystitis.

Conclusions:

• Hyperbaric oxygen therapy is a successful treatment for radiation-induced hemorrhagic cystitis refractory to standard regimens.
• HBOT is well-tolerated, even in cancer patients with advanced disease and significant blood loss.
• The majority of patients achieve long-term remission with hyperbaric oxygen therapy.