The effectiveness of hyperbaric oxygen therapy (HBOT) in radiation-induced haemorrhagic cystitis.

INTRODUCTION: Radiation cystitis is one of the possible complications from pelvic radiotherapy. Hyperbaric oxygen (HBOT) improves tissue oxygenation and healing of scarred tissue.

AIMS: To assess the efficacy of hyperbaric oxygen therapy (HBOT) in the management of radiation-induced haemorrhagic cystitis in patients with urological cancers.

METHODS: This is a retrospective review on all patients with macroscopic haematuria secondary to radiation induced haemorrhagic cystitis who were treated with hyperbaric oxygen therapy (HBOT) between 2009 and 2013. The primary outcome is symptomatic assessment (either complete resolution, partial resolution or no change).

RESULTS: A total of 12 patients with radiation-induced cystitis secondary to urological cancer were included in this study with a mean follow-up of 443 days. The mean age was 78 years. Complete resolution of haematuria was seen in six out of 12 patients. Partial response was achieved in two patients where one required two courses of HBOT and one required three courses of HBOT. As a result, the overall improvement of haematuria after HBOT was 67%. A total of four patients had no response to HBOT.

CONCLUSION: Radiation-induced cystitis is a difficult clinical problem to treat. HBOT is not a magic bullet but it may be another alternative treatment option we have at this point in time.