July 13, 2020
In the article “Hyperbaric oxygen therapy for radiation cystitis after pelvic radiotherapy: Systematic review of the recent literature”, the authors carry out a systematic review of the literature less than 10 years old that analyzes the efficiency of Hyperbaric Oxygen Therapy in reducing the symptoms associated with radiation cystitis.
Twenty articles were analyzed for this review. The total study population was 815 patients with ages between 15 and 91 years. Most of the patients (58.9%) received radiation treatment due to prostate cancer. The remaining percentage received treatment due to the endometrial, bladder, anal, and colorectal cancer, among others. The radiation dose range ranged from 36 to 138 Gy to the pelvis.
It was performed and evaluation of hematuria, blood transfusion, quality of life of the patient, the time between the end of radiotherapy treatment, and the beginning of Hyperbaric Oxygen Therapy and other related symptoms. The therapy sessions were conducted in single or multi-place hyperbaric chambers, between 60 and 120 minutes. The results were classified into three categories: complete response, partial response, and no response.
In the study with the largest population (with 176 patients), the percentage of general response reached 89.8% (67.1% total response and 22.7% partial response). In the second-largest population study (which included 134 patients), 82.8% responded in three months of therapy.
In 20 studies, the overall response ranged from 64.8% to 100%. The weighted average was 86.4%. The complete response ranged from 20% to 100% and the average was 63.6%. The perception of a better quality of life increased in 75.8% of cases. Hyperbaric Oxygen Therapy did not present adverse effects in 35.2% of the patients.
Hyperbaric Oxygen Therapy had a lower response in patients who required blood transfusions, in those who received anticoagulation treatments due to the predisposition to bleeding, and in those in whom the time between the end of radiation treatment and the onset of hematuria was short since the therapy was more effective in repairing the bladder tissue due to cellular hypoxia. The radiation dose could also be related to the reappearance of symptoms. The patients who did not present the reappearance of symptoms underwent 18% less intense radiation.
Therefore, based on the bibliography, there are demonstrated the benefits of the application of Hyperbaric Oxygen Therapy in the treatment of cystitis symptoms associated with the application of radio oncological therapy.
Lauren Villeirs, Thomas Tailly, Piet Ost, Marjan Waterloos, Karel Decaestecker, Valerie Fonteyne, Charles Van Praet, Nicolaas Lumen. 2019. Hyperbaric Oxygen Therapy for Radiation Cystitis After Pelvic Radiotherapy: Systematic Review of the Recent Literature.