Denton A S, Clarke N W, Maher E J
Centre for Cancer Treatment, Mount Vernon Hospital, Rickmansworth Rd, Northwood, Middlesex, UK, HA6 2RN.
Cochrane Database Syst Rev. 2002;2002(3):CD001773. doi: 10.1002/14651858.CD001773.
Chronic radiation cystitis occurs a minimum of three months after completion of pelvic radiotherapy and represents a range of clinical symptoms for which there is as yet no recommended standard management.
The aim of this review was to identify the various non-surgical treatment options for the management of late chronic radiation cystitis and evaluate the evidence.
Synonyms for radiation therapy and for the spectrum of radiation toxicity to the bladder in both text and MeSH terms were combined and applied to a range of databases without restriction of year of publication, methodology or language.
The inclusion criteria included studies of interventions for the non-surgical management of all grades of late radiation cystitis.
Out of 80 relevant studies, there were no RCTs that met the inclusion criteria, but there were three prospective case series and two non-randomised studies which assessed different interventions and were not comparable.
Sixty-three reports met the stated inclusion criteria. The majority were predominantly retrospective case series with the exception of two trials which were unrandomised and unblinded studies with a control group for comparison of effect. Although these two trials, Micic 1988, (intravesical placental extract) and Milani 1988, (flavoxate) provided the strongest evidence they were not randomised and were essentially isolated controlled studies.
REVIEWER'S CONCLUSIONS: In such a relatively rare condition there are obvious difficulties in identifying sufficient patients to participate in a randomised controlled trial. The number of published reports is a reflection of the degree of medical interest that exists in providing therapeutic solutions for late radiation cystitis. However, in spite of the two studies of level IIA evidence, the absence of randomised controlled trials makes it impossible to draw any firm conclusions.
慢性放射性膀胱炎在盆腔放疗结束后至少三个月出现，表现为一系列临床症状，目前尚无推荐的标准治疗方法。
本综述的目的是确定晚期慢性放射性膀胱炎非手术治疗的各种选择，并评估相关证据。
将放疗以及膀胱放射性毒性谱在文本和医学主题词中的同义词进行组合，并应用于一系列数据库，不受出版年份、方法或语言限制。
入选标准包括所有级别晚期放射性膀胱炎非手术治疗干预措施的研究。
在80项相关研究中，没有符合入选标准的随机对照试验，但有三个前瞻性病例系列和两项非随机研究，这些研究评估了不同的干预措施，且缺乏可比性。
63份报告符合既定入选标准。除两项非随机、非盲法且设有对照组以比较疗效的试验外，大多数主要是回顾性病例系列。尽管这两项试验，即1988年米西奇（膀胱内注射胎盘提取物）和1988年米拉尼（黄酮哌酯）试验提供了最有力的证据，但它们并非随机试验，本质上是孤立的对照研究。
在这种相对罕见的疾病中，识别足够数量的患者参与随机对照试验存在明显困难。已发表报告的数量反映了为晚期放射性膀胱炎提供治疗方案所存在的医学关注程度。然而，尽管有两项IIA级证据的研究，但由于缺乏随机对照试验，无法得出任何确凿结论。
