Treatment of Radiation Induced Hemorrhagic Cystitis With Hyperbaric Oxygen.

Corman, John M.; McClure, Dale R.; Pritchett, R.A. Rees; Kozlowski, P.; Hampson, Neil B.

doi:10.1097/01.ju.0000063640.41307.c9

Cited by 116 publications

(86 citation statements)

References 14 publications

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“…Severe RTOG/EORCT grade III or worse bladder morbidity has been reported at 1% at 5 years, 1.4% at 10 years and 2.3% at 20 years following radiotherapy for cervical cancer (20). Radiation for prostate cancer may lead to moderate or severe haematuria in 3-5% of cases (10,12).…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…Hyperbaria related to HBO therapy increases bladder's tissue oxygen tension (14). Hyperoxia enhances neovascularization and growth of normal tissue (6,10,15,17). Angiogenesis is stimulated by tissue macrophages responding to the steep oxygen gradient (15).…”

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%

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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%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Hyperbaric oxygen therapy for HC patients has achieved encouraging success with no adverse effects in recent years, 25 especially for the patients induced from radiation, 40 which allows better tissue diffusion of oxygen, improving neoangiogenesis by increasing the vascular density of irradiated tissues. However, the wide application of this approach is limited by the requirement of a hyperbaric chamber and long procedure (20-30 days).…”

Section: Discussionmentioning

confidence: 99%

Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Han

Sun

et al. 2008

Bone Marrow Transplant

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Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury

Hampson

Holm

Wreford-Brown

et al. 2011

Cancer

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BACKGROUND: Although hyperbaric oxygen is used to treat chronic radiation tissue injury, clinical evidence supporting its efficacy has been limited to date. The authors report prospectively collected patient outcomes from a single center's large experience using hyperbaric oxygen to treat chronic radiation injury. METHODS: Since 2002, patient outcomes at the conclusion of a course of hyperbaric oxygen treatment for chronic radiation tissue injury at Virginia Mason Medical Center in Seattle have been graded by a board‐certified hyperbaric physician and prospectively recorded. From 2002 to 2010, a total of 525 patients received treatment for 1 of 6 forms of radionecrosis analyzed. After excluding 114 patients for incomplete records or treatment courses or for previous receipt of hyperbaric oxygen therapy, records of 411 patients were retrospectively reviewed in 2010, and outcomes were regraded by a second board‐certified physician. A positive clinical response was defined as an outcome graded as either “resolved” (90%‐100% improved) or “significantly improved” (50%‐89% improved). RESULTS: A positive outcome from hyperbaric treatment occurred in 94% of patients with osteoradionecrosis of the jaw (n = 43), 76% of patients with cutaneous radionecrosis that caused open wounds (n = 58), 82% of patients with laryngeal radionecrosis (n = 27), 89% of patients with radiation cystitis (n = 44), 63% of patients with gastrointestinal radionecrosis (n = 73), and 100% of patients who were treated in conjunction with oral surgery in a previously irradiated jaw (n = 166). CONCLUSIONS: The outcomes of 411 patients collected prospectively over 8 years strongly supported the efficacy of hyperbaric oxygen treatment for the 6 conditions evaluated. The response rates previously reported in numerous small series were supported by the responses achieved in this large, single‐center experience. Cancer 2012. © 2011 American Cancer Society.

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Treatment of Radiation Induced Hemorrhagic Cystitis With Hyperbaric Oxygen.

Abstract: Hyperbaric oxygen therapy for radiation induced hemorrhagic cystitis is an efficacious treatment modality for patients in whom other forms of management have failed.

Cited by 116 publications

References 14 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

Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury

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