To determine the incidence of radiation cystitis on Prostate Cancer (PCa) patients undergoing pelvic radiotherapy (RT), evaluating the most used management strategies, and identifying potential risk factors associated with the development of this condition.
A retrospective analysis was conducted using the PearlDiver™ Mariner database, containing patient records 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 radiation cystitis. Primary objective was to determine the overall incidence of radiation cystitis. Furthermore, we investigated its associated risk factors and management.
A total of 274,865 PCa patients underwent RT during the study period. Of these, 48,713 (17.7%) experienced hematuria following RT, while 7,721 (2.8%) were diagnosed with radiation cystitis. After the diagnosis, 2,307 patients (29.9%) received diagnostic or therapeutic endoscopic interventions. Only 59 patients (0.76%) underwent endovascular embolization, while 151 patients (1.95%) required cystectomy. Hyperbaric oxygen therapy, administered to 1,287 patients (16.67%), was the only treatment that displayed a significant upward trend. Multivariate logistic regression identified obesity (OR 1.29; 95% C.I. 1.23 - 1.35), smoking (OR 1.27; 95% C.I. 1.22 - 1.33), and diabetes (OR 1.32; 95% C.I. 1.26 - 1.39), as significant risk factors for radiation cystitis (all p-values < 0.001).
Radiation cystitis represents a rare complication after pelvic RT with significant clinical impact. Its incidence has remained stable throughout the study period. The identified risk factors corroborate the pathophysiology of radiation cystitis. Hyperbaric oxygen therapy was the only treatment to show an upward trend during the study period.
Urology. 2024 Apr 29 [Epub ahead of print]
Eugenio Bologna, Leslie Claire Licari, Antonio Franco, Francesco Ditonno, Celeste Manfredi, Cosimo De Nunzio, Alessandro Antonelli, Marco De Sio, Christopher Coogan, Srinivas Vourganti, Costantino Leonardo, Giuseppe Simone, Riccardo Autorino
Department of Urology, Rush University, Chicago, IL, USA; Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italy., Department of Urology, Rush University, Chicago, IL, USA; Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy., Department of Urology, Rush University, Chicago, IL, USA; Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy., Department of Urology, Rush University, Chicago, IL, USA; Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy., Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy., Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy., Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy., Department of Urology, Rush University, Chicago, IL, USA., Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy., Department of Urology, Rush University, Chicago, IL, USA. Electronic address: .