Department of Radiation Therapy, University of Otago, Wellington, New Zealand.
Radiation Oncology Department, Southern Blood and Cancer Centre, Dunedin Hospital, New Zealand.
Radiother Oncol. 2020 Aug;149:117-123. doi: 10.1016/j.radonc.2020.05.006. Epub 2020 May 13.
Acute radiation cystitis affects the quality of life of many prostate cancer patients. A previous pilot study suggested that cranberry capsules may decrease some of the symptoms of acute radiation cystitis. Here we further test their effectiveness in a multicentre double blinded placebo-controlled clinical trial.
A total of 108 prostate cancer patients were recruited at three New Zealand hospitals between September 2016 and January 2019. Out of this cohort, 101 patients provided datasets for analysis (51 men on cranberry capsules and 50 men on beetroot-containing placebo capsules). Patients took two capsules each morning during RT and for 2 weeks after completion of RT. Three measures were used to assess cystitis severity: modified RTOG, O'Leary interstitial cystitis scale and a sensitive novel radiation induced cystitis assessment scale (RICAS). Cystitis severity was scored at baseline and weekly thereafter during RT and for two weeks after completion of RT. Radiation protocols were stratified to conventional fractionation or hypo-fractionated radiation therapy (CHHiP) to the prostate or radiation to the prostate bed.
Cranberry capsules performed significantly worse than placebo capsules with respect to day time frequency and bladder control, using the more sensitive RICAS scale. No significant difference in cystitis severity was seen between patients receiving hypofractionation and those receiving conventional fractionation to the prostate gland.
Cranberry capsules were not superior to beetroot-containing placebo capsules in managing radiation cystitis in our prostate patient cohort. RICAS may be a useful tool for measuring radiation cystitis in future studies.
急性放射性膀胱炎影响许多前列腺癌患者的生活质量。先前的一项试点研究表明,蔓越莓胶囊可能会减轻急性放射性膀胱炎的一些症状。在这里,我们在一项多中心、双盲、安慰剂对照的临床试验中进一步测试了它们的疗效。
2016 年 9 月至 2019 年 1 月期间,在新西兰的三家医院共招募了 108 名前列腺癌患者。在这一组中,有 101 名患者提供了可用于分析的数据(51 名男性服用蔓越莓胶囊,50 名男性服用含甜菜根的安慰剂胶囊)。患者在放疗期间每天早上服用两次胶囊,在放疗结束后服用两周。使用三种措施评估膀胱炎的严重程度:改良 RTOG、O'Leary 间质性膀胱炎量表和一种敏感的新型放射性膀胱炎评估量表(RICAS)。在放疗期间和放疗结束后的两周内,每周评估膀胱炎的严重程度。根据常规分割或前列腺低分割放疗(CHHiP)或前列腺床放疗对放疗方案进行分层。
使用更敏感的 RICAS 量表,蔓越莓胶囊在日间频率和膀胱控制方面的表现明显逊于安慰剂胶囊。在接受低分割放疗和接受常规分割放疗的前列腺患者之间,膀胱炎的严重程度没有显著差异。
在我们的前列腺癌患者队列中,蔓越莓胶囊在治疗放射性膀胱炎方面并不优于含甜菜根的安慰剂胶囊。RICAS 可能是未来研究中测量放射性膀胱炎的有用工具。