Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis

Denton, A; Clarke, Noel W.; Maher, Jane

doi:10.1002/14651858.cd001773

Cited by 83 publications

(87 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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). In case of intractable haemorrhage arterial embolization or ligation and/or cystectomy represent definitive treatment, at the cost of increased morbidity.…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

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

View full text Add to dashboard Cite

show abstract

“…This usually occurs during the treatment period, and involves an acute inflammatory response and tissue edema. 4 The underlying pathology of late adverse effects is different from that seen in the acute reaction. Late-responding tissues, such as vascular and connective tissues, have a slow turnover rate; therefore, while they sustain radiation damage at the time of treatment, the effects are not expressed until repeated cell division is attempted.…”

Section: Pathologymentioning

confidence: 99%

“…Late-responding tissues, such as vascular and connective tissues, have a slow turnover rate; therefore, while they sustain radiation damage at the time of treatment, the effects are not expressed until repeated cell division is attempted. 4 For this reason, late radiation tissue injury can take several months to many years to develop, and is largely a function of the total radiation dose and fraction size. The pathological hallmark of late radiation tissue injury is obliterative endarteritis resulting in atrophy and fibrosis.…”

Section: Pathologymentioning

confidence: 99%

Management of radiation cystitis

2010

View full text Add to dashboard Cite

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.

show abstract

“…Most available data about radiation cystitis treatment come from a small number of descriptive studies or from expert opinions [2,4]. As clinical data are considered to have low quality then physicians, who are still facing patients with a disease hugely influencing quality of life, mostly base on their own experience.…”

Section: Introductionmentioning

confidence: 99%

The Choquet Integral Applied to Ranking Therapies in Radiation Cystitis

Rakus-Andersson

Frey

2015

Advances in Intelligent Systems and Computing

View full text Add to dashboard Cite

show abstract

Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis

Abstract: Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis.

Cited by 83 publications

References 52 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

The Choquet Integral Applied to Ranking Therapies in Radiation Cystitis

Contact Info

Product

Resources

About