HBOT for treatment of radiation cystitis consequent to radiation therapy for prostate cancer

A Japanese clinical research team recently published long-term follow-up data from a small series of patients treated with hyperbaric oxygen therapy (HBOT) to alleviate radiation cystitis as a side effect associated with radiation therapy for prostate cancer.

This study by Nakada et al. offers retrospective data from a series of 38 patients followed for an average of > 11 years. In addition to the abstract of their paper, the authors have offered some further thoughts on the benefits of HBOT in a series of “Beyond the abstract” comments on the UroToday web site.

Here are the core data from the original study:

  • The average age of the 38 patients was 68 ± 8 years.
  • All patients has radiation cystitis consequent to radiation therapy for prostate cancer.
  • All patients were treated with HBOT (at two atmospheric pressures for 90 minutes a day).
  • The average number of HBOT sessions was 62 ± 12.
  • The follow-up period was 11.6 ± 3.7 years.
  • High levels of efficacy (79 to 95 percent) were observed at 2 and 4 years of follow-up.
  • Efficacy levels were slightly lower (72 to 83 percent) at 7 years of follow-up, but stabilized thereafter.
  • Comparison of morbidity scores pre-treatment and at an average of 11.6 years after HBO therapy showed statistically significant improvement (p < 0.0005).
  • 28/38 patients (74 percent) had non-recurrence of their cystitis.
    • These 28 patients had received a significantly lower radiation dosage (18 percent lower; p < 0.001) than patients who had recurrence of their cystitis.
    • Time from onset of hematuria (blood in the urine) to start of HBOT was significantly shorter (30 percent; p < 0.001) among non-recurrent patients than among recurrent patients.

Nakada et al. conclude that HBOT for radiation cystitis in patients with prostate cancer is effective and beneficial, and that early application of HBOT following onset of hematuria seems to produce a favorable outcome in a high percentage of patients. However, it is notable that HBOT may be less effective among men with radiation cystitis who were given higher-dose forms of radiation therapy and among those who started HBOT some time after the initial signs of hematuria.

4 Responses

  1. I was not aware of what radiation cyctitis is or that it is a possible side effect of radiation therapy. I received therapy by CyberKnife in March of 2012. Please elaborate on the risk of its occurrence, the effects and symptoms.

  2. Radiation cystitis is a complication of radiation therapy (particularly when used to treat pelvic tumors such as prostate and bladder cancers). For details of radiation cystitis, please see this article on the e-Medicine web site.

  3. Aloha,

    My radiation cystitis started about 3 years after EBRT/IMRT. My HMO would not approve HBOT. We purchased a portable mild HBOT unit which, for about a year, delayed complete failure of the bladder/prostate.

    My bladder and prostate were removed in July. There is also damage to the rectum and anus. Pathology reported no prostate cancer detected. The radiation dose was on the high side. An MRI in July also showed radiation damage to the bones.


  4. I just finished the treatment. Good results were noticed about half-way through the 40-course treatment. I hope they hold.

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