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. 2002;2002(3):CD001773.
doi: 10.1002/14651858.CD001773.

Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis

A S Denton  1 , N W Clarke, E J Maher
Affiliations

Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis

A S Denton et al. Cochrane Database Syst Rev. 2002.

Abstract

Background: Chronic radiation cystitis occurs a minimum of three months after completion of pelvic radiotherapy and represents a range of clinical symptoms for which there is as yet no recommended standard management.

Objectives: The aim of this review was to identify the various non-surgical treatment options for the management of late chronic radiation cystitis and evaluate the evidence.

Search strategy: Synonyms for radiation therapy and for the spectrum of radiation toxicity to the bladder in both text and MeSH terms were combined and applied to a range of databases without restriction of year of publication, methodology or language.

Selection criteria: The inclusion criteria included studies of interventions for the non-surgical management of all grades of late radiation cystitis.

Data collection and analysis: Out of 80 relevant studies, there were no RCTs that met the inclusion criteria, but there were three prospective case series and two non-randomised studies which assessed different interventions and were not comparable.

Main results: Sixty-three reports met the stated inclusion criteria. The majority were predominantly retrospective case series with the exception of two trials which were unrandomised and unblinded studies with a control group for comparison of effect. Although these two trials, Micic 1988, (intravesical placental extract) and Milani 1988, (flavoxate) provided the strongest evidence they were not randomised and were essentially isolated controlled studies.

Reviewer's conclusions: In such a relatively rare condition there are obvious difficulties in identifying sufficient patients to participate in a randomised controlled trial. The number of published reports is a reflection of the degree of medical interest that exists in providing therapeutic solutions for late radiation cystitis. However, in spite of the two studies of level IIA evidence, the absence of randomised controlled trials makes it impossible to draw any firm conclusions.

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Conflict of interest statement

None known

Figures

1.1
1.1. Analysis
Comparison 1: The effect of placental extract on late radiation cystitis, Outcome 1: Clinical improvement of RT cystitis with placental extract
1.2
1.2. Analysis
Comparison 1: The effect of placental extract on late radiation cystitis, Outcome 2: Improvement in bladder mucosa in late RT cystitis following treatment with placental extract
2.1
2.1. Analysis
Comparison 2: The effect of different doses of flavoxate on the clinical and urodynamic parameters, Outcome 1: Changes in the clinical score for 600 mg and 1200 mg of flavoxate
2.2
2.2. Analysis
Comparison 2: The effect of different doses of flavoxate on the clinical and urodynamic parameters, Outcome 2: Changes in the pressure in the bladder at first desire pre and post treatment with flavoxate doses
2.3
2.3. Analysis
Comparison 2: The effect of different doses of flavoxate on the clinical and urodynamic parameters, Outcome 3: Changes in the volume of fluid in the bladder at first desire pre‐post tx with different doses of flavoxate
2.4
2.4. Analysis
Comparison 2: The effect of different doses of flavoxate on the clinical and urodynamic parameters, Outcome 4: Reduction in bladder pressure at capacity pre and post tx with different doses of flavoxate
2.5
2.5. Analysis
Comparison 2: The effect of different doses of flavoxate on the clinical and urodynamic parameters, Outcome 5: Changes in the bladder volume at capacity pre and post tx with different doses of flavoxate
See this image and copyright information in PMC

References

References to studies included in this review

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Milani 1988 {published data only}
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References to studies excluded from this review

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