Hyperbaric oxygen – an effective tool to treat radiation morbidity in prostate cancer

Mayer, Ramona; Klemen, H.; Quehenberger, Franz; Sankin, Oliver; Mayer, Eric; Hackl, A.; Smolle‐Juettner, Freyja‐Maria

doi:10.1016/s0167-8140(01)00430-3

Cited by 66 publications

(44 citation statements)

References 18 publications

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“…Moreover, some of them may have serious systematic side effects or may exacerbate bladder fibrosis which was initiated by radiation treatment, leading to a small-capacity bladder (1,(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). A recent Cochrane Database systematic literature review on non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis concluded that in the absence of randomized controlled studies it is impossible to set definitive rules for treatment (21).…”

Section: Discussionmentioning

confidence: 99%

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Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: To examine the safety and efficacy of hyperbaric oxygen as the primary treatment for Grade IV radiation-induced haemorrhagic cystitis. Materials and Methods:Hyperbaric oxygen was prospectively applied as a primary treatment option in 11 patients with Grade IV radiation cystitis. Primary endpoint was the incidence of complete and partial response to treatment. Secondary endpoints included the duration of response, the correlation of treatment success-rate to the interval between the onset of haematuria and initiation of therapy, blood transfusion need and total radiation dose, the number of sessions to success, the avoidance of surgery and the overall survival.Results: All patients completed therapy without complications for a mean follow-up of 17.82 months (range 3 to 34). Mean number of sessions needed was 32.8 (range 27 to 44). Complete and partial response rate was 81.8% and 18.2%, respectively. However, in three patients the first treatment session was not either sufficient or durable giving a 72.7% rate of durable effect. Interestingly, all 9 patients with complete response received therapy within 6 months of the haematuria onset compared to the two patients with partial response who received therapy at 8 and 10 months from the haematuria onset, respectively (p = 0.018). The need for blood transfusion (p = 0.491) and the total radiation dose (p = 0.259) were not correlated to success-rate. One patient needed cystectomy, while all patients were alive at the end of follow-up. Conclusions: Early primary use of hyperbaric oxygen to treat radiation-induced grade IV cystitis is an effective and safe treatment option.

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Section: Discussionmentioning

confidence: 99%

“…All studies published on HBO therapy for radiation cystitis are not randomized or controlled. The majority constitutes retrospective reviews and case series (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13), with only one study being prospective in nature (14). In all these studies HBO was used as a secondary treatment option.…”

Section: Introductionmentioning

confidence: 99%

Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

et al. 2014

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“…A number of investigators have studied HBOT in this setting. 47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64 An advantage of HBOT in these patients is the absence of the adverse effects on bladder structure or function that may be seen with other therapies, such as formalin or silver nitrate instillations, while avoiding the need for surgery. HBOT is also very well tolerated, with few adverse effects-the most common being pressure-related in the form of ear and sinus barotrauma.…”

Section: Hyperbaric Oxygen Therapymentioning

confidence: 99%

Management of radiation cystitis

2010

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Acute radiation cystitis occurs during or soon after radiation treatment. It is usually self-limiting, and is generally managed conservatively. Late radiation cystitis, on the other hand, can develop from 6 months to 20 years after radiation therapy. The main presenting symptom is hematuria, which may vary from mild to severe, life-threatening hemorrhage. Initial management includes intravenous fluid replacement, blood transfusion if indicated and transurethral catheterization with bladder washout and irrigation. Oral or parenteral agents that can be used to control hematuria include conjugated estrogens, pentosan polysulfate or WF10. Cystoscopy with laser fulguration or electrocoagulation of bleeding points is sometimes effective. Injection of botulinum toxin A in the bladder wall may relieve irritative bladder symptoms. Intravesical instillation of aluminum, placental extract, prostaglandins or formalin can also be effective. More-aggressive treatment options include selective embolization or ligation of the internal iliac arteries. Surgical options include urinary diversion by percutaneous nephrostomy or intestinal conduit, with or without cystectomy. Hyperbaric oxygen therapy (HBOT) involves the administration of 100% oxygen at higher than atmospheric pressure. The reported success rate of HBOT for radiation cystitis varies from 60% to 92%. An important multicenter, doubleblind, randomized, sham-controlled trial to evaluate the effectiveness of HBOT for refractory radiation cystitis is currently being conducted.

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“…Other treatments are described, like hyperbaric chamber oxygenation, that may affect angiogenesis by stimulating microvascularization. Anyway, all published series are retrospective and highly heterogeneous regarding cases included, although they report improvement rates without adverse effects of up to 65% (12)(13)(14). Another inconvenience is the high number of daily sessions necessary for improvement (20-40), and the scarce availability of specialized centres.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of argon plasma coagulation in the treatment of chronic actinic proctitis

Tormo

Wikman-Jorgensen

Castillo

et al. 2009

Rev. esp. enferm. dig.

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Introduction: there are two kinds of actinic proctitis -one is acute and self-limited, and lasts about 3 months; the other is chronic and develops months to years after radiation therapy. The incidence of chronic actinic proctitis is about 5-20% of radiated prostate tumors.Objective: to evaluate the effectiveness of argon plasma coagulation in the treatment of chronic actinic proctitis.Material and method: a retrospective search of patients with the diagnosis of actinic proctitis. The number of argon plasma coagulation therapies needed to achieve the symptom resolution was analyzed.Results: we found 22 patients with a diagnosis of actinic proctitis. Nineteen were males (86.7%) and three (13.6%) were females. Nineteen patients (86.4%) had a diagnosis of prostate adenocarcinoma, one had a diagnosis of squamous-cell cervix carcinoma (4.5%), and two had a diagnosis of endometrial carcinoma (9.1%). The mean number of coagulation sessions needed for symptom resolution was 2.58 (absolute range 1-7) with a median of 2 sessions.Conclusion: multiple treatments are described in the literature. None of them have shown promising results. Our results suggest that argon plasma coagulation is effective in the treatment of this condition, and achieves a rapid and sustained response with few sessions and a good safety profile.

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Hyperbaric oxygen – an effective tool to treat radiation morbidity in prostate cancer

Cited by 66 publications

References 18 publications

Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

Management of radiation cystitis

Effectiveness of argon plasma coagulation in the treatment of chronic actinic proctitis

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