Patient Reported Outcome Measures Following Hyperbaric Oxygen Therapy for Radiation Cystitis: Early Results From the Multicenter Registry for Hyperbaric Oxygen Therapy.

PURPOSE: To determine changes in patient reported hematuria and urinary symptoms after hyperbaric oxygen (HBO2 ) treatment for radiation cystitis (RC).

METHODS: We analyzed prospectively data from the Multicenter Registry for Hyperbaric Oxygen Therapy Consortium collected within a week of beginning and ending HBO2 . Measures included the modified Radiation Therapy Oncology Group (RTOG) Hematuria Scale, Urinary Distress Inventory Short Form (UDI-6), and EuroQOL EQ-5D-5L. RTOG hematuria and UDI scores were compared using the sign test. Logistic regression was used to evaluate characteristics associated with hematuria improvement.

RESULTS: 470 registry patients had RC. The median age, number of HBO2 sessions, and years after radiation were 73 (IQR 12) years, 39 (IQR 10) sessions, and 5 (IQR 8) years respectively. 84% (393/470) had prostate-cancer-related radiation. EQ-5D-5L scores improved from 0.83 (IQR 0.14) to 0.85 (IQR 0.22), P < .001. 370 had complete RTOG hematuria scores which improved from 2 (IQR 2) to 0 (IQR 2), P < .001. 246 had complete UDI-6 ratings which decreased from 33.3 (IQR 44) to 22.2 (IQR 33) P < .001. Regression analysis of those with visible hematuria pre HBO2 , showed lower improvement odds associated with higher HBO2 hematuria scores (OR: 0.44; 95% confidence interval (CI) 0.26-0.73, P < .01), a smoking history (OR: 0.44, 95% CI: 0.21-0.92, P = .03), or a non-prostate cancer history (0.32 (95%CI:0.10-0.99, P = .05).

CONCLUSIONS: HBO2 for RC improved reported hematuria, urinary function, and quality of life. Higher baseline hematuria scores, smoking, and non-prostate cancer history were associated with a lower odds of hematuria improvement.