Ponce Blasco Paula, Sánchez Llopis Anna, Barrios Arnau Laura, Salvador Marín Manuel, Di Capua Sacoto Carlos, Rodrigo Aliaga Miguel
Servicio de Urología. Hospital General Universitario de Castellón. Castellón de la Plana. España.
Servicio de Medicina Hiperbárica. Hospital General Universitario de Castellón. Castellón de la Plana. España.
Arch Esp Urol. 2021 Mar;74(2):215-223.
To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in the treatment of hemorrhagic radiation cystitis (HRC).
Retrospective study of patients diagnosed with hematuria secondary to HRC after pelvic radiation from January 2005 to January 2017 who were treated with HBOT. Demographic and clinical variables were collected. A descriptive univariate and multivariate statistical analysis using Cox regression was carried out. The treatment was considered effective when there was a total or partial remission of the hematuria based on the Radiation Therapy Oncology Group (RTOG) scoring schema. Partial remission was defined as the presence of hematuria grade 2 or less.
A total of 67 patients with a mean age of 68,6 years (39-87) were included. 65,7% men and 34,3% women. The RT was administered in 64,2% of the cases by urological cause, prostate cancer. The av-erage dose of RT was 75,24 Gy (45-180). The mean from the RT to the HBOT treatment was 55,97 months (4-300) and from the beginning of the hematuria until the treatment was 11,3 months (1-48). Response was observed in 51 (76,1%) patients, total in 50,7% and partial in 25,4% of cases. Patients with a degree of hematuria less than 3, those who were administered more than 30 sessions and those who did not require transfusion or hospital admission, responded significantly bet-ter to treatment with HBOT (p<0.05) according to the univariate and multivariate analysis. No adverse effects related to treatment were reported, only one patient was excluded due to claustrophobia.
Hyperbaric oxygen therapy is an effective and safe treatment for the management of hematuria due to radiological cystitis secondary to radiotherapy. A better response was observed in patients with a lower degree of hematuria and those who could be administered a greater number of sessions.
评估高压氧治疗（HBOT）对出血性放射性膀胱炎（HRC）的疗效。
对2005年1月至2017年1月期间因盆腔放疗后继发HRC导致血尿而接受HBOT治疗的患者进行回顾性研究。收集人口统计学和临床变量。采用Cox回归进行描述性单变量和多变量统计分析。根据放射治疗肿瘤学组（RTOG）评分方案，当血尿完全或部分缓解时，治疗被认为有效。部分缓解定义为血尿分级为2级或更低。
共纳入67例患者，平均年龄68.6岁（39 - 87岁）。男性占65.7%，女性占34.3%。64.2%的病例因泌尿外科疾病（前列腺癌）接受放疗。放疗平均剂量为75.24 Gy（45 - 180）。从放疗至HBOT治疗的平均时间为55.97个月（4 - 300），从血尿开始至治疗的平均时间为11.3个月（1 - 48）。51例（76.1%）患者有反应，其中完全缓解占50.7%，部分缓解占25.4%。根据单变量和多变量分析，血尿程度小于3级、接受超过30次治疗且不需要输血或住院的患者，对HBOT治疗的反应明显更好（p<0.05）。未报告与治疗相关的不良反应，仅1例患者因幽闭恐惧症被排除。
高压氧治疗是治疗放疗后继发性放射性膀胱炎所致血尿的一种有效且安全的方法。血尿程度较低且能接受更多次数治疗的患者反应更佳。
