Overview
Radiation cystitis is a severe complication from pelvic radiation
therapy, causing symptoms like hematuria, urinary pain, and incontinence. This
study investigates the impact of hyperbaric oxygen (HB02) therapy on mortality and
blood transfusion needs in radiation cystitis patients. Patients who completed 20, 30,
or 40 HB02 sessions showed a survival benefit. Increased age, lower hematocrit,
and decreased glomerular filtration rate were linked to higher mortality risk, while
more HB02 sessions reduced this risk. Starting HB02 more than 30 days post-
diagnosis increased the likelihood of needing blood transfusions.
Organization: Intermountain Healthcare, headquartered in Salt Lake City, Utah, is
the largest nonprofit health system in the Intermountain West, serving seven states.
It includes 34 hospitals, 400 clinics, and serves over 3 million telehealth patients.
The organization focuses on clinical excellence, affordability, and community
support.
Background
Radiation cystitis affects over 10% of patients receiving pelvic
radiation therapy. With nearly 10 million pelvic cancer survivors expected by 2026,
many are at risk for this condition. The financial burden for inpatient treatment of
radiation cystitis is significant, estimated at $63.5 million USD annually. Radiation
cystitis can be acute or delayed, with symptoms ranging from minor irritative voiding
to severe complications like gross hematuria and bladder necrosis. HB02 therapy,
which involves breathing pure oxygen in a pressurized chamber, has shown benefits
in promoting tissue healing and reducing inflammation.
Methods
The study used a self-service data platform to analyze patient data from
2006 to 2021. Patients with radiation cystitis were identified using specific diagnostic
codes, excluding those with bladder cancer. Data included demographic information,
comorbid conditions, treatments received, and outcomes like mortality and blood
transfusion requirements. The platform enabled rapid data queries, facilitating timely
analysis.
Challenges
The main challenge was completing the retrospective analysis to
identify HB02 therapy benefits. Data access for patients outside the health system
was limited, but the self-service platform expedited data retrieval for those within the
system.
Results to Date
Out of 575 patients diagnosed with radiation cystitis, 199
received HB02 therapy. The mean age was 72 years, and 75% were male. HB02
therapy conferred a survival benefit, with more sessions correlating with higher
survival odds. Increased age, lower hematocrit, and decreased glomerular filtration
rate were associated with higher mortality risk. Patients starting HB02 more than 30
days post-diagnosis were more likely to need transfusions before diagnosis.
Transfusion needs decreased after starting HB02.
Conclusion
HB02 therapy is associated with decreased mortality and improved
quality of life for radiation cystitis patients. Delays in diagnosis and referral for HB02
may increase transfusion needs. The study highlights the importance of early
intervention and the benefits of HB02 therapy in managing radiation cystitis.
