Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up

Pereira, Daniel Queiroz; Ferreira, Carlos Noronha; Catarino, Raquel; Correia, Tiago; Cardoso, André; Reis, F.; Cerqueira, Manuel D.; Prisco, R.; Camacho, Óscar

doi:10.1016/j.acuroe.2020.03.004

Cited by 11 publications

(18 citation statements)

References 21 publications

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“…Se obtuvo una respuesta duradera, y 4 de cada 5 pacientes estaban libres de hematuria clínicamente relevante a los 4 años del tratamiento con THO. Nuestros resultados son equiparables a otros estudios retrospectivos publicados, que han informado mejoría en el 70-90% de los casos tratados (1,4,15,(17)(18)(19). Además, estos resultados también han sido corroborados en un ensayo clínico aleatorizado de pacientes con cistitis rádica tratados con THO (estudio RICH-ART).…”

Section: Discussionunclassified

“…La cistitis rádica es una complicación temible de la radioterapia pélvica (RT). Sus manifestaciones clínicas pueden incluir síntomas urinarios irritativos, dolor y hematuria recurrente que puede comprometer la vida del paciente (1).…”

Section: Introductionunclassified

“…El papel del urólogo es fundamental para evitar demoras en su diagnóstico y tratamiento. Este retraso se ha relacionado con un peor pronóstico, pudiendo causar la pérdida funcional o anatómica de la vejiga, con el consecuente impacto negativo en la calidad de vida del paciente (1). Entre las causas que explican esta posible demora destacan: ausencia de protocolos comunes entre urólogos y oncólogos radioterápicos; falta de evidencia clínica (2-4); escasa utilización de escalas para valorar la severidad clínico-cistoscópica de la cistitis rádica, y dificultad para acceder a alternativas terapéuticas que han mostrado beneficio clínico.…”

Section: Introductionunclassified

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Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Sarrió-Sanz¹,

Sánchez‐Caballero²,

Martínez-Cayuelas³

et al. 2022

Arch. Esp. Urol.

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The aim was to study the efficacy and tolerance in patients with haemorrhagic radiation-induced cystitis (HRC) treated with hyperbaric oxygen therapy (HOT) and analyze which factors were related to the response to the treatment. Material and methods: We performed a retrospective cohort study of patients treated with HOT for HRC symptoms in a provincial referral centre from 2010 to 2020. We evaluated clinical response to treatment, number of hospitalizations due to HRC and subjective response using the PGI-I questionnaire. Results: We treated 52 patients, with a median of 30 sessions, during 6 months and 40 months (6-68 months) of follow-up. 69.2% of patients responded completely and 21,2% partially. The 53.2% of patients improved before the first 10 sessions. Reduction of hospitalizations/per year due to haematuria from 2.8 to 1.1 (p=0,001). The 73,5% of patients stated that they were "very much better" or "much better" after treatment. During the follow-up, 15.4% of patients had recurrence of HRC. 9.6% of the patients required salvage cystectomy. The patients with a highest RTOG-EORTC scale had more risk to still with symptoms (OR 3.01 (IC95 1.48 -6.16). All patients were able to complete the proposed treatment plan with good tolerance to HOT. Conclusions: These results show the clinical benefit of HOT in the treatment of HRC, with a reduction of the number of hospitalizations and a subjective improvement. Resumen:Objetivo: conocer eficacia y tolerancia de la hiperoxigemia en cámara hiperbárica (THO) en pacientes con cistitis rádica hemorrágica (CRH) y analizar factores asociados a respuesta al tratamiento. Material y métodos: estudio de cohorte retrospectivo de pacientes tratados mediante THO por CRH en centro de referencia entre 2010 y 2020. Evaluamos respuesta clínica de la hematuria, número de ingresos hospitalarios por CRH y satisfacción subjetiva mediante cuestionario PGI-I. Resultados: tratamos 52 pacientes, mediana de 30 sesiones con 6 meses de tratamiento y 40 meses (6-68 meses) de seguimiento. El 69,2% obtuvo respuesta completa y el 21,2% respuesta parcial. El 53,2% mejoró antes de las 10 primeras sesiones. La reducción de los ingresos hospitalarios/año por hematuria fue de 2,8 a 1,1 (p=0,001). El 73,5% de pacientes señaló encontrarse "Mucho mejor" o "un poco mejor" tras el tratamiento. Durante el seguimiento, el 15,4% presentaron recurrencia de hematuria. Del total de la serie, 9,6% de pacientes precisó cistectomía de rescate. El análisis de supervivencia mostró una asociación entre el tiempo de desaparición de la hematuria y la clasificación de la escala RTOG-EORTC (OR 3,01 (IC95 1,48-6,16). Todos los pacientes pudieron finalizar el plan de tratamiento propuesto con buena tolerancia a la THO. Conclusiones: la THO muestra beneficio clínico en el tratamiento de la CRH, redujo los episodios de hospitalización por hematuria y mejoró la calidad de vida de los pacientes, con buena tolerancia al tratamiento.

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Section: Discussionunclassified

Section: Introductionunclassified

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Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Sarrió-Sanz¹,

Sánchez‐Caballero²,

Martínez-Cayuelas³

et al. 2022

Arch. Esp. Urol.

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“…In fact, Pereira et al reviewed 105 patients diagnosed with RIHC whowere treated with HBOT between 2007 and 2016. After a median follow-up of 63 months, 76.3% had a complete response [ 31 ]. Cardinal et al evaluated the benefits of HBOT through a meta-analysis of data from 602 patients treated with HBOT for hemorrhagic radiation cystitis.…”

Section: Current Treatments and Clinical Trialsmentioning

confidence: 99%

Chronic Inflammation and Radiation-Induced Cystitis: Molecular Background and Therapeutic Perspectives

Hélissey

Cavallero

Brossard

et al. 2020

Cells

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Radiation cystitis is a potential complication following the therapeutic irradiation of pelvic cancers. Its clinical management remains unclear, and few preclinical data are available on its underlying pathophysiology. The therapeutic strategy is difficult to establish because few prospective and randomized trials are available. In this review, we report on the clinical presentation and pathophysiology of radiation cystitis. Then we discuss potential therapeutic approaches, with a focus on the immunopathological processes underlying the onset of radiation cystitis, including the fibrotic process. Potential therapeutic avenues for therapeutic modulation will be highlighted, with a focus on the interaction between mesenchymal stromal cells and macrophages for the prevention and treatment of radiation cystitis.

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“…Ultrasonic imaging can judge the conditions in the blood vessels and provide a basis for a further treatment, and it plays an increasingly important role in the examination and treatment of thrombosis diseases. [3][4][5] Common cystitis is an inammatory lesion of the bladder caused by bacterial infection and is a potential precancerous lesion, 6,7 it is oen found in middle-aged women and early diagnosis and treatment is particularly important. At present, the application of ultrasonic contrast agent in the study of bladder inammation is relatively rare and has great research potential.…”

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confidence: 99%

A new PLA–Tween composited drug-carrying C60–Fe₃O₄ multifunctional ultrasound contrast agent based on three kinds of lesions

et al. 2021

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Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up

Cited by 11 publications

References 21 publications

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Chronic Inflammation and Radiation-Induced Cystitis: Molecular Background and Therapeutic Perspectives

A new PLA–Tween composited drug-carrying C60–Fe₃O₄ multifunctional ultrasound contrast agent based on three kinds of lesions

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Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up

Cited by 11 publications

References 21 publications

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Chronic Inflammation and Radiation-Induced Cystitis: Molecular Background and Therapeutic Perspectives

A new PLA–Tween composited drug-carrying C60–Fe3O4 multifunctional ultrasound contrast agent based on three kinds of lesions

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Product

Resources

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A new PLA–Tween composited drug-carrying C60–Fe₃O₄ multifunctional ultrasound contrast agent based on three kinds of lesions