Early hyperbaric oxygen therapy improves outcome for radiation-induced hemorrhagic cystitis
Auteur(s)
KIAN TAI CHONG, NEIL B. HAMPSON, AND JOHN M. CORMAN
Jaartal
2004
Tijdschrift
Urology 65: 649–653, 2005.
Type publicatie
Onderzoek
Onderzoek
Retrospectief cohort onderzoek met 12 mnd follow-up
Aantal
60 (55 man, 5 vrouw)
Selectiecriteria
Patienten met hemorrhagische radiatiecystitis,
Methode
All patients received HBO2 therapy at 2.36 atm absolute pressure, with 90 minutes of 100% oxygen breathing per treatment. The outcome was assessed after at least 12 months of follow-up. We evaluated patient demographics, types of pelvic malignancy and radiotherapy, total radiation dose, onset and severity of hematuria, and prior intravesical management. Clinical improvement was defined as the absence of, or reduction in, macroscopic hematuria.
Resultaat
A total of 60 patients (55 men and 5 women), mean age 70 years, received an average of 33 HBO2 treatments (range 9 to 63). Of the 60 patients, 48 (80%) had either total or partial resolution of hematuria.
When treated within 6 months of hematuria onset, 96% (27 of 28) had complete or partial symptomatic resolution (P 0.003). All 11 patients with previous clot retention had clinical improvement if treated within 6 months of hematuria onset (P 0.007). Prior intravesical chemical instillation did not affect the clinical outcome. Patients who had undergone primary, adjuvant, or salvage external beam pelvic radiotherapy showed response rates of 81%, 83%, and 78%, respectively (P 0.950).
When treated within 6 months of hematuria onset, 96% (27 of 28) had complete or partial symptomatic resolution (P 0.003). All 11 patients with previous clot retention had clinical improvement if treated within 6 months of hematuria onset (P 0.007). Prior intravesical chemical instillation did not affect the clinical outcome. Patients who had undergone primary, adjuvant, or salvage external beam pelvic radiotherapy showed response rates of 81%, 83%, and 78%, respectively (P 0.950).
Conclusie
Our results show that delivery of HBO2 therapy within 6 months of hematuria onset is associated with a greater therapeutic response rate. Treatment efficacy was independent of prior intravesical therapy and the timing of radiotherapy.
Externe link
Indicatie
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