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Review
. 2024 Aug 12;13(16):4724.
doi: 10.3390/jcm13164724.

Efficacy and Safety of Hyperbaric Oxygen Therapy for Radiation-Induced Hemorrhagic Cystitis: A Systematic Review and Meta-Analysis

Teng-Kai Yang  1   2 , Yu-Jen Wang  2   3 , Hsing-Ju Li  4 , Ya-Fang Yu  4 , Kai-Wen Huang  4   5 , Jason Chia-Hsien Cheng  3   4   6
Affiliations
Review

Efficacy and Safety of Hyperbaric Oxygen Therapy for Radiation-Induced Hemorrhagic Cystitis: A Systematic Review and Meta-Analysis

Teng-Kai Yang et al. J Clin Med. .

Abstract

Background: Radiation-induced hemorrhagic cystitis (RHC) is a chronic inflammatory disease in patients undergoing radiation therapy that causes a cluster of symptoms which may have a latent period of months to years. The current non-invasive treatments include drug treatment and hyperbaric oxygen therapy (HBOT), which has been widely applied for RHC so far but with limited evidence. Thus, we conducted a systematic review and meta-analysis to clarify the effects and safety of HBOT for RHC. Methods: A systematic review and meta-analysis were utilized, searching in the databases of Embase, Pubmed, and Web of Science. The primary endpoint of the present study was complete remission of hematuria. The meta-analysis was conducted using a random effects model, and a pooled odds ratio with 95% CI was calculated. Results: A total of 317 studies were searched and fourteen articles with 556 patients were collected. The results showed that a total of 500 patients (89.9%) had symptom improvement, and the pooled results demonstrated that 55% of patients with HBOT had complete remission of hematuria (95% CI 51-59%). Conclusions: A significant improvement of symptoms when treated with HBOT was shown in this meta-analysis for patients with RHC.

Keywords: hematuria; hyperbaric oxygen therapy; meta-analysis; radiation-induced hemorrhagic cystitis; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram showing screening and selection process [14]. * The initial search identified 317 published (registered) articles from online databases including PubMed, EMBASE and Web of Science.
Figure 2
Figure 2
Risk of bias graph: a review of authors’ judgements about each risk of bias item presented as percentages across all included studies [16,17,18,19,20,21,22,23,24,25,26,27,28,29].
Figure 3
Figure 3
Forest plot of hazard ratio of complete remission using a random effects model [16,17,18,19,20,21,22,23,24,25,26,27,28,29].
Figure 4
Figure 4
Forest plot of hazard ratio of partial remission using a random effects model [16,17,18,19,20,21,22,23,24,25,26,27,28,29].
Figure 5
Figure 5
Forest plot of adverse events using a random effects model [16,17,18,19,20,21,22,23,24,25,26,27,28,29].
See this image and copyright information in PMC

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