Patient Reported Outcome Measures following Hyperbaric Oxygen Therapy for Radiation Cystitis: Updated Results from the Multicenter Registry for Hyperbaric Oxygen Therapy Consortium
Rachel Moses, MD1, Eileen Brandes, MD1, Devin Cowan, BS2, Nicole Harlan, MD1, Judy Rees, PhD, MPH3, William Bihrle, III, MD1, Jay Buckey, Jr., MD1.
1Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA, 2Dartmouth College, Hanover, NH, USA, 3Dartmouth Geisel School of Medicine, Hanover, NH, USA.
BACKGROUND: Prior studies demonstrate hyperbaric oxygen (HBOT) is associated with reduced bladder bleeding interventions in hemorrhagic radiation cystitis. Previously, we demonstrated feasibility of collecting urine related patient reported outcome measures (PROMs) via the Multicenter Registry for HBOT. The purpose of this study is to evaluate change in urinary related PROMs before and after HBOT in a larger, updated cohort.
METHODS: Prospectively collected data from 19 sites in the Multicenter Registry for Hyperbaric Oxygen Therapy Consortium were analyzed. Measures included a hematuria scale adapted from the RTOG/EROCT radiation scale for cystitis, Urinary Distress Inventory (UDI) and a question on hematuria severity and quantity. Data obtained on the first and last days of HBOT were compared using Wilcoxon rank sum test. Proportions were compared using chi-square tests.
RESULTS: 213 patients had complete RTOG/EROTC hematuria data, 137 had UDI data and 130 had both. Patients were on average 70 (+/- 12) years old, 50/213 were diabetic, 80/213 are current or former smokers and 181/213 developed radiation cystitis due to prostate cancer related radiation treatment. Referral for HBOT occurred approximately 7.0 +/- 5.8 years following radiation. The average number of treatments was 36 +/- 11. RTOG/EROTC hematuria scores were significantly improved post HBOT (2.3 pre vs 1.0 post, p=0.001). UDI scores were significantly improved, post HBOT (35.8+/-26.4 vs 26.6+/-22.7, p<0.01).
CONCLUSIONS: In a novel, multi-institutional prospective data set, we demonstrate HBOT is associated with improved urine related PROMs for individuals undergoing HBOT for radiation cystitis. Continued expansion of the registry may provide more generalizable results and allow for analysis of factors leading to change in UDI scores.
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