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Immediate and Long-Term Hematuria Outcomes in Patients with Mild to Moderate Radiation Cystitis Treated with Hyperbaric Oxygen Therapy: A retrospective analysis
Allison G. Booher, B.A.
1,
Kathryn McGonagle, B.S.1, Janet Peacock, PhD
1, Elaine Silverman, M.D.
2, Pamela Hannigan, M.D.
2, Lawrence Bornt, R.N.
2, William Bihrle, III, M.D.
2, Jay Buckey, Jr., M.D.
2, Rachel Moses, M.D., M.P.H.
2.
1Geisel School of Medicine at Dartmouth College, Hanover, NH, USA,
2Dartmouth Health, Lebanon, NH, USA.
Introduction
Hyperbaric oxygen (HBO
2) therapy is associated with reduced radiation cystitis (RC) bladder bleeding events, however outcomes for patients with RC-related gross hematuria are poorly understood. This study evaluated mild to moderate RC related HBO
2 short term (days) and longer term (years) outcomes.
Methods
Using the HBO
2 treatment registry at our center, we performed a retrospective chart review on 44 patients who received HBO
2 for Radiation Therapy Oncology Group (RTOG) Grade 2-3 RC. Short-term outcomes were assessed by rates of gross and microscopic hematuria at baseline and 20, 40, and greater than 40 HBO
2 treatment sessions. Hematuria rates and average number of admissions were compared with paired t -tests. Long-term outcomes were evaluated by readmission rates for hematuria management within 1 or more years following HBO
2 completion and compared between radiation indications via Kaplan Meier analysis.
Results
Table 1 reports baseline characteristics and HBO2 outcomes. Figure 1 shows the change in hematuria over HBO
2 treatment course; 82% of patients with intermittent macroscopic hematuria demonstrated resolution of gross hematuria by 40 treatments. We found a significant reduction in mean number of hematuria admissions between the year before and after HBO
2 (0.76, 95CI 0.35-1.17, p<0.001, Table 1). 12 patients (27.3%) were admitted for hematuria in the follow-up period, 75% within one year following HBO
2. There was no difference in post HBO
2 admission rates between radiation therapy indications (p=0.942).
Conclusion
HBO
2 produces short-term resolution of gross hematuria and long-term reduction in hospitalization rates for bladder bleeding events in patients with mild to moderate RC.
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