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473 Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis
473
Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis Eur Urol Suppl 2014;13;e473
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Oliveira T., Romão A. Portuguese Navy Center for Underwater and Hyperbaric Medicine, Dept. of Urology, Lisbon, Portugal INTRODUCTION & OBJECTIVES: Due to its morbidity and mortality, radiation-induced hemorrhagic cystitis is an important complication of pelvic radiotherapy. The burden of this condition is significantly increased due to the limited effectiveness of the current conservative techniques. Hyperbaric oxygen therapy has showed to be effective in the management of late radiation injuries, including radiation-induced cystitis. The aim of our study was to analyse the efficacy of hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to verify if it was influenced by a series of external variables. MATERIAL & METHODS: Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Centre for Underwater and Hyperbaric Medicine, from August 1994 to September 2009, were retrospectively analysed. Patients received daily 90 minute sessions, with 100% oxygen at 2,5 atmospheres. Evolution of macroscopic hematuria was used to analyse treatment efficacy. RESULTS: From a total of 176 treated patients, 23,9% presented with other radiation-induced soft tissue lesions. After an average on 37 sessions, 89,8% of patients showed resolution of hematuria. Patients that underwent 20 sessions or less had a 90% resolution rate, whereas patients receiving 21 to 40 sessions showed 96,5% resolution (p=0,042). Resolution of hematuria decreased gradually with the increase of time from the beginning of symptoms to institution of hyperbaric oxygen therapy (p=0,199). Patients that needed transfusional therapy showed lesser resolution rate of the macroscopic hematuria (p=0,026). No relation was found between the evolution of hematuria and any other variable. CONCLUSIONS: In concordance to previous reports, radiation-induced hemorrhagic cystitis was successfully managed with hyperbaric oxygen therapy. Our results show that, in order to have maximum results, hyperbaric oxygen treatment should be established as soon as possible. Treatment efficacy was higher in patients that underwent more than 20 sessions, but there was no greater benefit after 40 sessions.
Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis Eur Urol Suppl 2014;13;e473
Print! Print!
Oliveira T., Romão A. Portuguese Navy Center for Underwater and Hyperbaric Medicine, Dept. of Urology, Lisbon, Portugal INTRODUCTION & OBJECTIVES: Due to its morbidity and mortality, radiation-induced hemorrhagic cystitis is an important complication of pelvic radiotherapy. The burden of this condition is significantly increased due to the limited effectiveness of the current conservative techniques. Hyperbaric oxygen therapy has showed to be effective in the management of late radiation injuries, including radiation-induced cystitis. The aim of our study was to analyse the efficacy of hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to verify if it was influenced by a series of external variables. MATERIAL & METHODS: Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Centre for Underwater and Hyperbaric Medicine, from August 1994 to September 2009, were retrospectively analysed. Patients received daily 90 minute sessions, with 100% oxygen at 2,5 atmospheres. Evolution of macroscopic hematuria was used to analyse treatment efficacy. RESULTS: From a total of 176 treated patients, 23,9% presented with other radiation-induced soft tissue lesions. After an average on 37 sessions, 89,8% of patients showed resolution of hematuria. Patients that underwent 20 sessions or less had a 90% resolution rate, whereas patients receiving 21 to 40 sessions showed 96,5% resolution (p=0,042). Resolution of hematuria decreased gradually with the increase of time from the beginning of symptoms to institution of hyperbaric oxygen therapy (p=0,199). Patients that needed transfusional therapy showed lesser resolution rate of the macroscopic hematuria (p=0,026). No relation was found between the evolution of hematuria and any other variable. CONCLUSIONS: In concordance to previous reports, radiation-induced hemorrhagic cystitis was successfully managed with hyperbaric oxygen therapy. Our results show that, in order to have maximum results, hyperbaric oxygen treatment should be established as soon as possible. Treatment efficacy was higher in patients that underwent more than 20 sessions, but there was no greater benefit after 40 sessions.