Main Session
Sep 28
PQA 04 - Breast Cancer, Patient Reported Outcomes/QoL/Survivorship, Functional Radiation Medicine, Hematologic Malignancies, Palliative Care, and International/Global Oncology

2810 - Factors Associated with Hematuria Resolution and Post Treatment Hematuria Related Admissions in Patients with Chronic Radiation Cystitis Treated with Hyperbaric Oxygen Therapy

03:00pm - 04:00pm ET
Poster Hall - Exhibit Hall A
Screen: 31
POSTER

Presenter(s)

Rachel Moses, MD - Dartmouth Health, Lebanon, NH

A. Booher1, K. McGonagle1, J. Peacock2, P. Hannigan3, L. Bornt3, W. Bihrle III4, E. M. Silverman4, J. C. Buckey5, and R. A. Moses3; 1Geisel School of Medicine, Hanover, NH, 2Department of Epidemiology; Geisel School of Medicine at Dartmouth College, Hanover, NH, 3Dartmouth Hitchcock Medical Center, Lebanon, NH, 4Dartmouth Health, Lebanon, NH, 5Geisel School of Medicine at Dartmouth & Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH

Purpose/Objective(s):

Hyperbaric oxygen (HBO2) therapy reduces chronic radiation cystitis (RC) bladder bleeding events; however, the time course of hematuria resolution and frequency of post-treatment admission are not well understood.

Materials/Methods:

We performed a review of prospectively collected data on patients who received at least 30 HBO2 sessions for RC associated with gross hematuria at our center.

The primary outcome was time to short term point of care urine (POCU) hematuria resolution. The secondary outcomes included rates of readmission for hematuria management pre and post HBO2 completion and patient factors associated with these outcomes. Chi square analyses evaluated associations between clinical characteristics and short- and long-term outcomes.

Results:

A total of 42 patients met inclusion criteria, 60% (26/43), 79% (34/42), and 100% (12/12) of patients presenting for HBO2 with macroscopic hematuria demonstrated resolution of gross hematuria by 20, 40, and 60 treatments respectively. Hematuria admissions decreased after HBO2 (1.2 admissions pre vs 0.3 post, 95%CI 0.4-1.2, p<0.001). 12 patients (27%) were readmitted following HBO2. A greater proportion of those readmitted had Radiation Therapy Oncology Group (RTOG) scores = 3, (42%, (5/12) vs 7% (1/14), p<0.05), and more severe baseline patient-reported hematuria (36% (9/25) vs 7% (1/15), p<0.05).

Conclusion:

HBO2 was associated with short-term hematuria resolution and fewer long-term hospitalizations for RC hematuria. More severe baseline RC indicators predicted post-HBO2 hematuria hospitalizations. These findings suggest that some patients may benefit from tailored treatment courses and that early HBO2 initiation may lead to better long-term outcomes.