Objective: To assess the safety and efficacy of hyperbaric oxygen (HBO) for treating radiation cystitis a long-term follow-up study was done in patients with prostate cancer, the second most common malignancy in Japan. Patients and Methods: A total of 38 patients at an age of 68 ± 8 years with radiation cystitis following irradiation of prostate cancer were treated with HBO at 2 absolute atmospheric pressures for 90 min daily. The average number of HBO treatment sessions in each patient was 62 ± 12. The follow-up period was 11.6 ± 3.7 years. We evaluated objective and subjective symptoms periodically with special reference to the initiation timing of HBO therapy. Results: High efficacy ratios of objective and subjective findings were obtained at 2 and 4 (79–95%) years, respectively. After 7 years’ follow-up, these ratios decreased slightly (72–83%) but still remained stable thereafter (75–88%) without any serious accident. Comparison of late morbidity scores before and 11.6 years after HBO therapy showed significant improvement (p < 0.0005). Twenty-eight patients (74%) obtained nonrecurrent outcome. They had received 18% lower (p < 0.001) radiation dosage than recurrent patients. The interval between the onset of hematuria and start of HBO treatment in nonrecurrent patients was 30% shorter (p < 0.001) than that of recurrent patients. Conclusions: We elucidated the long-term safety and beneficial effect of HBO therapy of radiation cystitis in patients with prostate cancer. Early application of HBO treatment after the onset of hematuria appears to produce favorable outcome.

1.
Zelefsky MJ, Chan H, Hunt M, Yamada Y, Shippy AM, Amols H: Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 2006;176:1415–1419.
2.
Hampson NB, Holm JR, Wreford-Brown CE, Feldmeier J: Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury. Cancer DOI: 10.1002/cncr.26637.
3.
Gill S, Thomas J, Fox C, Kron T, Rolfo A, Leahy M, Chander S, Williams S, Tai KH, Duchesne GM, Foroudi F: Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy. Radiat Oncol 2011;6:145.
4.
Bekelman JE, Mitra N, Efstathiou J, Liao K, Sunderland R, Yeboa DN, Armstrong K: Outcomes after intensity-modulated versus conformal radiotherapy in older men with nonmetastatic prostate cancer. Int J Radiat Oncol Biol Phys 2011;81:e325–e334.
5.
Weiss JP, Mattei DM, Neville EC, Hanno PM: Primary treatment of radiation-induced hemorrhagic cystitis with hyperbaric oxygen: 10-year experience. J Urol 1994;51:1514–1517.
6.
Marx RE, Ehler WJ, Tayapongsak P, Pierce LW: Relationship of oxygen dose to angiogenesis induction in irradiated tissue. Am J Surg 1990;160:519–524.
7.
Del Pizzo JJ, Chew BH, Jacobs SC, Sklar GN: Treatment of induced hemorrhagic cystitis with hyperbaric oxygen: long-term followup. J Urol 1998;160:731–733.
8.
Bevers RFM, Bakker DJ, Kurth KH: Hyperbaric oxygen treatment for haemorrhagic radiation cystitis. Lancet 1995;346:803–805.
9.
Parsons CI: Successful treatment of radiation cystitis with sodium pentosanponylsulfate. J Urol 1986;36:813–814.
10.
Mark LB, Carroll PR, Dugan TC, Anscher MS: The response of the urinary bladder, urethra, and ureter to radiation and chemotherapy. Int J Radiat Oncol Biol Phys 1995;31:1257–1280.
11.
Veerasarn V, Khorprasert C, Lorvidhaya V, Sangruchi S, Tantivatana T, Narkwong L, Kongtharanat Y, Chitaapanarux I, Tesavibul C, Panichevaluk A, Puribhat S, Sangkittipaiboon S, Sookpreedee L, Lertsanguansinchai P, Phromratanapongse P, Rungpoka P, Trithratipvikul S, Lojanapiwat B, Ruangdikokrai S, Ngampanprasert P: Reduced recurrence of late hemorrhagic radiation cystitis by WF10 therapy in cervical cancer patients. A multicenter, randomized, two-arm, open-label trial. Radiol Oncol 2004;73:179–185.
12.
Mathews R, Rajan N, Josefson I, Comporesi E, Makhuli Z: Hyperbaric oxygen therapy for radiation induced hemorrhagic cystitis. J Urol 1999;161:435–437.
13.
Corman JM, McClure D, Pritchett R, Kozlowski P, Hampson NB: Treatment of hemorrhagic cystitis with hyperbaric oxygen. J Urol 2003;169:2200–2202.
14.
Chong KT, Hampson NB, Corman JM: Early hyperbaric oxygen therapy improves outcome for radiation-induced hemorrhagic cystitis. Urology 2004;65:649–653.
15.
Cerutti PA: Pro-oxidant states and tumor promotion. Science 1985;227:375–381.
16.
Chong KT, Hampson NB, Bostwick D§G, Vessella RL, Corman, JM: Hyperbaric oxygen does not accelerate latent in vivo prostate cancer: implications for the treatment of radiation-induced haemorrhagic cystitis. BJU Int 2004;94:1275–1278.
17.
Feldmeier JJ: Hyperbaric oxygen for delayed radiation injuries. UHM 2004;31:133–145.
18.
Mayer R, Klemen H, Quehenberger F, Sankin O, Mayer E, Hackl E, Smolle-Juettner FM: Hyperbaric oxygen an effective tool to treat radiation morbidity in prostate cancer. Radiother Oncol 2001;61:151–156.
19.
Hampson NB, Corman JM: Rate of delivery of hyperbaric oxygen treatments does not affect response in soft tissue radionecrosis. UHM 2007;34:329–334.
20.
Nakada T: Hyperbaric oxygenation of experimental bladder tumor. I. Tissue oxygen tension of the rabbit bladder during hyperbaric oxygenation. Eur Urol 1988;14:145–149.
21.
Nakada T, Saito Y, Chikenji M, Koda S, Higuchi M, Kawata K, Ishida S, Takahashi S, Kondo S, Kubota Y, Kubota I, Shimizu Y: Therapeutic outcome of hyperbaric oxygen and basic fibroblast growth factor on intractable skin ulcer in legs: preliminary report. Plast Reconstr Surg 2006;117:646–651.
22.
Norkool DM, Hampson NE, Gibbons RP, Weissman RM: Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis. J Urol 1993;150:332–334.
23.
Yoshida T, Kawashima A, Ujike T, Uemura M, Nishimura K, Miyoshi S: Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis. Int J Urol 2008;15:639–641.
24.
Mohamad Al-Ali B, Trummer H, Shamloul R, Zigeuner R, Pummer K: Is treatment of hemorrhagic radiation cystitis with hyperbaric oxygen effective? Urol Int 2010;84:467–470.
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