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

OBJECTIVES: 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.

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

Objectives: 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 andsubjective 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 ofhospitalizations/per year due to haematuria from 2.8 to 1.1 (p=0,001). The 73,5% of patients stated that they were “very muchbetter” or “much better” after treatment. During the follow-up, 15.4% of patients had recurrence of HRC. 9.6% of the patientsrequired 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. (AU)

Objetivo: conocer eficacia y tolerancia de la hiperoxigemia en cámara hiperbárica (THO) en pacientes con cistitis rádica hemorrágica (CRH) y analizar factores asociadosa respuesta al tratamiento.Material y métodos: estudio de cohorte retrospectivode pacientes tratados mediante THO por CRH en centro dereferencia entre 2010 y 2020. Evaluamos respuesta clínicade la hematuria, número de ingresos hospitalarios por CRHy 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 el21,2% respuesta parcial. El 53,2% mejoró antes de las 10primeras 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 pocomejor” tras el tratamiento. Durante el seguimiento, el15,4% presentaron recurrencia de hematuria. Del total dela serie, 9,6% de pacientes precisó cistectomía de rescate.El análisis de supervivencia mostró una asociación entre eltiempo de desaparición de la hematuria y la clasificación dela escala RTOG-EORTC (OR 3,01 (IC95 1,48-6,16). Todoslos pacientes pudieron finalizar el plan de tratamiento propuesto con buena tolerancia a la THO.Conclusiones: la THO muestra beneficio clínico enel tratamiento de la CRH, redujo los episodios de hospitalización por hematuria y mejoró la calidad de vida de lospacientes, con buena tolerancia al tratamiento. (AU)