Pd57-02 Incidence and Management of Radiation Cystitis After Pelvic Radiotherapy for Prostate Cancer: Analysis From a National Database

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy (PD57)1 May 2024PD57-02 INCIDENCE AND MANAGEMENT OF RADIATION CYSTITIS AFTER PELVIC RADIOTHERAPY FOR PROSTATE CANCER: ANALYSIS FROM A NATIONAL DATABASE Eugenio Bologna, Leslie Claire Licari, Antonio Franco, Francesco Ditonno, Celeste Manfredi, Cosimo De Nunzio, Giuseppe Simone, Alessandro Antonelli, Marco De Sio, Morgan Sturgis, Christopher Coogan, Edward E. Cherullo, Ephrem O. Olweny, Srinivas Vourganti, and Riccardo Autorino Eugenio BolognaEugenio Bologna , Leslie Claire LicariLeslie Claire Licari , Antonio FrancoAntonio Franco , Francesco DitonnoFrancesco Ditonno , Celeste ManfrediCeleste Manfredi , Cosimo De NunzioCosimo De Nunzio , Giuseppe SimoneGiuseppe Simone , Alessandro AntonelliAlessandro Antonelli , Marco De SioMarco De Sio , Morgan SturgisMorgan Sturgis , Christopher CooganChristopher Coogan , Edward E. CherulloEdward E. Cherullo , Ephrem O. OlwenyEphrem O. Olweny , Srinivas VourgantiSrinivas Vourganti , and Riccardo AutorinoRiccardo Autorino View All Author Informationhttps://doi.org/10.1097/01.JU.0001008808.16085.aa.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radiation cystitis (RC) is a form of hemorrhagic cystitis — albeit rare — induced by radiation therapy (RT) to the pelvis. This condition arises due to obliterative endarteritis caused by hypoxia, resulting in spontaneous bleeding and it can result in atrophy and fibrosis. Its management is not standardized. In this study, we assess the incidence, trends, and management of RC in patients who underwent RT for prostate cancer (PCa). METHODS: A retrospective analysis was conducted using the PearlDiver™ Mariner database, containing de- HIPAA compliant identified patient records (over 41 billion) compiled between 2011 and 2022. International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes were employed to identify population and outcomes. We evaluated patients who underwent RT for PCa and subsequently developed RC during the study period. The primary objective was to determine the overall incidence of RC. Furthermore, we investigated prevalence and management trends of RC. RESULTS: A total of 274,865 PCa patients underwent RT during the study period. Of these, 48,713 (17.7%) experienced at least one episode of hematuria following the initiation of RT, while 7,721 (2.8%) were subsequently diagnosed with RC. Hematuria had a median onset of 36.4 months (IQR: 41.9), and RC 37.3 months (IQR: 44.2). After the diagnosis, 2.307 patients (29.9%) received diagnostic or therapeutic endoscopic interventions. Only 59 patients (0.76%) underwent endovascular embolization to treat or to prevent vesical bleeding, while 151 patients (1.95%) ultimately required cystectomy with a urinary diversion. Notably, hyperbaric oxygen therapy, administered to 1,287 patients (16.67%), was the only treatment that displayed a significant upward trend over the study period. Logistic regression analysis revealed that the Charlson Comorbidity Index (CCI) was correlated with a heightened risk for the development of RC (OR=1.03, 95% C.I. 1.02-1.04, p<0.001). CONCLUSIONS: RC represents a complication after pelvic RT with significant clinical impact and implications for patients' quality of life. The lack of treatment standards, the heterogeneity of therapeutic strategies, and the failure to consolidate any specific approach highlight that we are still far from optimal management of this condition. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1208 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Eugenio Bologna More articles by this author Leslie Claire Licari More articles by this author Antonio Franco More articles by this author Francesco Ditonno More articles by this author Celeste Manfredi More articles by this author Cosimo De Nunzio More articles by this author Giuseppe Simone More articles by this author Alessandro Antonelli More articles by this author Marco De Sio More articles by this author Morgan Sturgis More articles by this author Christopher Coogan More articles by this author Edward E. Cherullo More articles by this author Ephrem O. Olweny More articles by this author Srinivas Vourganti More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement PDF downloadLoading ...