Hyperbaric oxygen treatment for haemorrhagic radiation cystitis

Bevers, Rob F. M.; Bakker, Dirk J.; Kh, Kurth

doi:10.1016/s0140-6736(95)91620-2

Cited by 149 publications

(105 citation statements)

References 10 publications

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“…4 Therapeutic effects of HBO for radiation-induced hemorrhagic cystitis were initially described by Weiss in 1985. 5 To date, several case series of radiation-induced hemorrhagic cystitis have been reported 3,[6][7][8][9][10] ( Table 2), and most authors have concluded that HBO therapy is effective. In our study, the complete response rate was 75%, compatible with these former studies.…”

Section: Discussionmentioning

confidence: 99%

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Hyperbaric oxygen therapy for radiation‐induced hemorrhagic cystitis

Yoshida¹,

Kawashima²,

Ujike³

et al. 2008

Int J of Urology

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Hyperbaric oxygen (HBO) therapy has recently emerged as a potential primary option for the management of hemorrhagic cystitis. We review our experience treating hemorrhagic cystitis with HBO. Between January 2001 and May 2007, eight patients with radiation-induced hemorrhagic cystitis underwent HBO therapy. There were five men and three women with a mean age of 64.3 years (47-73). Radiation was given for local disease, and the mean dosage delivered was 56.6 Gy (42-70). The mean duration between the onset of hematuria and the beginning of HBO therapy was 8.9 months (3-34). Mean follow-up period was 15.5 months (2-31). Hematuria resolved completely in six of the eight patients, one of whom suffered recurrence of hematuria and was treated with HBO until the hematuria resolved again. The response rate was 75%, compatible with the previous reports, and no side-effects of HBO were noted. HBO treatment should be attempted for radiation-induced hemorrhagic cystitis.

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Section: Discussionmentioning

confidence: 99%

“…To our knowledge, all published reports on radiation-induced hemorrhagic cystitis treatment with HBO have been retrospective case series, except the study by Bevers 7 and no randomized trials have been performed. One of the reasons for the lack of adequate trials is difficulty with quantifying the severity of hematuria.…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy for radiation‐induced hemorrhagic cystitis

Yoshida¹,

Kawashima²,

Ujike³

et al. 2008

Int J of Urology

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“…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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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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“…33 Surgical procedures to control HC in cases of uncontrollable life-threatening hemorrhage include: percutaneous nephrostomy, open cystostomy, bladder packing, hydrostatic tamponade of the bladder, 34 selective embolization of branches of the internal iliac arteries and cystectomy. 16 Patients treated with hyperbaric oxygen 35,36 (sessions of 100% oxygen inhalation at 2-3 bar for 60-90 min/day) achieved 92% of responses with no adverse effects, but a hyperbaric chamber is required and is a prolonged procedure (20-30 days). More recently, the use of neodymium YAG laser was reported to stop gross hematuria in three of three pediatric patients with HC.…”

Section: Discussionmentioning

confidence: 99%

Intravesical rhGM-CSF for the treatment of late onset hemorrhagic cystitis after bone marrow transplant

Vela‐Ojeda

Tripp-Villanueva

Sánchez-Cortés

et al. 1999

Bone Marrow Transplant

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Summary:In the present study, we assessed the clinical effect of recombinant human granulocyte-macrophage colonystimulating factor (rhGM-CSF) in the treatment of refractory, grade III-IV hemorrhagic cystitis (HC) in six patients who underwent bone marrow transplantation (BMT). These were four males and two females, aged 24-40 years (median age 30.5 years). All received allogeneic BMT from HLA-identical siblings after preparation with busulfan-cyclophosphamide. HC was evident 24.5 days (range 15-33 days) after BMT. Median duration of HC before treatment was 5 days (range 4-9 days). Treatment consisted of intravesical instillation of rhGM-CSF (400 g) for 3 consecutive days. A complete response was observed in three patients, the other three showed a partial response. Median time to achieve response was 36 h (range 0.2-72 h). Hematuria was controlled after the first (two patients), second (two patients) or third (two patients) dose of intravesical rhGM-CSF. Patients were discharged from the hospital 10.5 days (range 3-41 days) after treatment. All patients have been followed for up to 10 months and none have required further treatment. No systemic or bladder side-effects have been observed. Although our results indicate that intravesical instillation of rhGM-CSF is effective in the treatment of HC, a phase II clinical trial, including a larger series of patients, is needed. Keywords: GM-CSF; hemorrhagic cystitis; BMT Hemorrhagic cystitis (HC) is a well-recognized and potentially fatal complication commonly observed in patients who receive high-dose cyclophosphamide (Cy). The incidence in BMT patients is 10-20%. 1-3 Acrolein, a metabolite of Cy, has been implicated as a causative agent. 4 HC after high-dose Cy is prevented by bladder irrigation, hyperhydration 5 and sulfhydryl-containing compounds such as 2-mercapto-ethane (mesna), 6 that inactivate acrolein in the urine. Other known causes of HC include exposure to busulfan, radiation, GVHD and viruses including adenovirus, 7 polyomavirus 8 and cytomegalovirus.HC can be treated by performing hyperhydration, intraCorrespondence: Dr J Vela-Ojeda, Apartado postal 14-878, código postal 07001, México, DF México

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Hyperbaric oxygen treatment for haemorrhagic radiation cystitis

Cited by 149 publications

References 10 publications

Hyperbaric oxygen therapy for radiation‐induced hemorrhagic cystitis

Hyperbaric oxygen therapy for radiation‐induced hemorrhagic cystitis

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

Intravesical rhGM-CSF for the treatment of late onset hemorrhagic cystitis after bone marrow transplant

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