Hyperbaric oxygen therapy completely resolves post-radiation haematuria in 52.1% of cases. - GreenMedInfo Summary
Evaluation of Hyperbaric Oxygen Therapy in the Treatment of Radiation-Induced Haemorrhagic Cystitis.
Urology. 2016 Apr 25. Epub 2016 Apr 25. PMID: 27125879
OBJECTIVE: To evaluate the efficacy of hyperbaric oxygen therapy (HBO) in the treatment of post-radiation haematuria (PRH) and to identify the predictive factors for a successful outcome.
MATERIALS AND METHODS: We conducted a retrospective study and included all patients treated with HBO for PRH in a university hospital centre between January 2003 and December 2013. We studied the patients' clinical characteristics, radiotherapy indication, treatments preceding HBO, the grade of haematuria diagnosed based on the CTCAE classification v 4.03 and the efficacy of HBO. The success of HBO was defined as the total or partial resolution of haematuria.
RESULTS: We included 71 patients with a median age of 72 (39-87) years. PRHs were severe (grade≥3) in 50 (70.4%) of the cases. Radiotherapy was indicated in the treatment of prostate cancer in 61 (85.9%) patients. The median length of time between haematuria and HBO was 8 (1-154) months. Prior to HBO, 46 (64.8%) patients underwent electrocoagulation of the bladder. HBO sessions were compounded by 9 cases of barotraumatic otitis, 5 cases of transient visual disturbance, and one case of finger paresthesia. On average, 29 (3-50) sessions were carried out. Treatment was effective in 46 (64.8%) patients, 37 (52.1%) of whom were completely cured. A haematuria grade of less than 3 was a predictive factor in successful treatment (p=0.027). Median follow-up was 15 (1-132) months.
CONCLUSION: Hyperbaric oxygen therapy completely resolves post-radiation haematuria in 52.1% of cases. Prolonged patient follow-up is required in order to confirm the efficacy of this treatment.