3318 - A Study on the Safety and Efficacy of Hyperbaric Oxygen Therapy as a First-Line Treatment for Chronic Urinary System Injury in Post-Radiotherapy Prostate Cancer Patients

12:45pm - 02:00pm PT

Hall F

Screen: 21

POSTER

Presenter(s)

Xin Qi, MD, MS - Peking University First Hospital, Beijing, Beijing

X. Qi¹, H. Zhang¹, J. Y. Chen¹, Y. Bai¹, Y. Wang², and H. Z. Li¹; ¹Department of Radiation Oncology, Peking University First Hospital, Beijing, China, ²Rehabilitation Center, Fuxing Hospital, Capital Medical University, Beijing, China

Purpose/Objective(s):

In recent years, advancements in radiotherapy technology have led to higher radiation doses, resulting in an increased incidence of chronic radiation-induced injuries. Previous studies have demonstrated that hyperbaric oxygen therapy (HBOT) effectively alleviates chronic radiation injury and associated symptoms, though it is typically used as a secondary treatment following unsuccessful drug or endoscopic interventions. This study retrospectively analyzed patients with chronic cystitis and urethritis following radiotherapy at our center, evaluating the efficacy and safety of HBOT as a primary treatment.

Materials/Methods:

Patients diagnosed with grade 3 or higher radiation-induced urethritis and cystitis after prostate cancer radiotherapy between 2022 and 2024 were included in this retrospective analysis. HBOT was recommended as the first-line treatment. The EPIC questionnaire was utilized to assess treatment outcomes before and after HBOT. HBOT was administered in an air pressurized chamber, with patients inhaling 100% oxygen for 60 minutes at 1.8-2.2 atm, five days per week. Treatment continued until complete remission was achieved.

Results:

A total of 23 patients were included, with a mean age of 68 years. Eight patients underwent radical radiotherapy, while 15 received postoperative radiotherapy. Radical radiotherapy protocols involved 70Gy/25 fractions in the prostate area and 47.5Gy/25 fractions. Postoperative radiotherapy protocols included 62.5Gy/25 fractions in the surgical bed. Thirty percent of patients had diabetes, and 39% were smokers. The average interval from the completion of radiotherapy to the onset of urethral symptoms was 11 months (range: 1-50 months). The median time from symptom onset to initiation of HBOT was 3 months (range: 1-15 months). The median number of HBOT sessions was 20 (range: 10-60). Common urethral symptoms included hematuria, dysuria, and perineal pain. With a median follow-up period of 6 months (range: 1-21 months),treatment outcomes showed that 43.5% of patients achieved complete remission, 47.8% achieved partial remission, and 8.7% (2 patients) did not respond to HBOT. One patient was later diagnosed with ureteral cancer and experienced hematuria improvement after transurethral resection. Another had undergone transurethral resection of the prostate prior to radiotherapy. The most common complication was barotraumatic otitis media, occurring in 4% of cases.

Conclusion:

Hyperbaric oxygen therapy as a first-line treatment for chronic bladder and urethral injuries following radiotherapy demonstrates high efficacy, good safety, low cost, and high patient acceptance. Given the extended survival periods of prostate cancer patients after radical radiotherapy, this treatment should be actively promoted to patients with chronic urinary system injuries. Urologists and radiotherapists should be informed of this effective therapeutic option.