Lewis
Hyperbaric oxygen reduced gross haematuria and may improve quality of life for patients with radiation cystitis.
| Clinical Bottom Line: 1. Hyperbaric oxygenation was associated with improvement in gross haematuria in the short term 2. Some longer-term benefit in haematuria, severity score and quality of life, but all patients received HBOT, so not a randomised outcome. |
Citation/s:Lewis AL, Hardy KR, Huang ET, Bolotin T, Clark JM, Thom SR. Hyperbaric oxygen therapy decreases gross haematuria and improves quality of life in patients with radiation cystitis. Undersea and Hyperbaric Medicine 2005; 32(4)236
Three-part Clinical Question: For patients with radiation cystitis, does hyperbaric oxygen therapy compared to standard approaches to treatment, result in any reduction in haematuria, pain or other related symptoms?
Search Terms: Radiation, cystitis, haematuria
The Study:Non-blinded randomised cross-over trial with intention-to-treat.
The Study Patients: Symptomatic radiation cystitis including gross haematuria.
Control group (N = 26 ; 19 analysed): Standard therapy (no details) for six weeks, then crossed over to HBOT arm.
Experimental group (N = 26 ; 19 analysed): 100% oxygen at an unspecified pressure daily for six weeks, then crossed to standard arm.
The Evidence:
|
Outcome |
Time to Outcome |
Control group rate |
Hyperbaric group rate |
Relative risk reduction |
Absolute risk reduction |
Number needed to treat |
|
Resolution of gross haematuria |
12 weeks |
0.12 |
0.54 |
368% |
0.42 |
2 |
|
^ |
95% CIs: |
170% to 566% |
0.12 to 0.65 |
2 to 5 |
|
Non-Event Outcomes |
Time to outcome/s |
Result |
|
Prostatitis severity survey |
12 weeks |
Improved after HBOT, but not statistically significant |
|
Quality of Life score |
12 weeks |
Better, P = 0.007 |
|
Long-term follow-up |
1.5 yrs |
Trends to improvement |
Comments:
1. Small study reported in abstract only
2. Cross-over design so that any results longer than six weeks do not represent a randomised comparison
3. Little details of the outcomes measured and the figures above remain speculative to some degree
Appraised by: Mike Bennett, Sydney; Wednesday, 11 July 2007Email: [m.bennett@unsw.edu.au]
Kill or Update By: December 2020
