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. 2013 Oct 11;112(7):885–897. doi: 10.1111/bju.12291

Table 4.

Summary of the key studies on intravesical therapy used in chemical- and RT-induced cystitis

Author Study design Patients, n Treatment Efficacy Adverse effects
Chondroitin sulphate
 Hazewinkel et al. (2011) [59] Comparative pilot Patients with gynaecological malignancies undergoing RT, 20 Chondroitin sulphate vs no chondroitin sulphate HC not reported. Trend towards less bothersome urogenital symptoms in treatment group Well tolerated
Sodium hyaluronate
 Shao et al. (2012) [60] Randomised Patients with pelvic malignancies undergoing RT, 36 Sodium hyaluronate vs HBO Complete response: UTI: 42.8% vs 10.0% in first 6 months (P = 0.034)
6 months: 87.5% vs 75.0%
12 months: 75.0% vs 50.0% NS at 12 and 18 months
18 months: 50.0% vs 45.0% (all NS)
Decrease in voiding frequency: significant at 6 months in both groups (P < 0.05) and at 12 months for sodium hyaluronate (P < 0.05)
VAS: significant improvement maintained for 18 months in both groups.
 Sommariva et al. (2010) [61] Prospective Consecutive patients with cystitis receiving CT for bladder cancer or RT for prostate cancer, 69 Sodium hyaluronate After 4 weeks, bladder capacity increased in all patients, and urgency and pain disappeared. No adverse effects observed
97% reported complete relief of dysuria and pain
 Delgado et al. (2003) [62] Retrospective Consecutive patients with cervix/uterine cancer undergoing RT, 90 Standard of care vs standard of care alone plus sodium hyaluronate RT toxicity:* Not reported
Week 4: 1.33 vs 0.71 (P < 0.005)
End of RT: 1.24 vs 0.71 (P < 0.004)
  Samper Ots et al. (2009) [63] Retrospective Patients with acute vesical toxicity caused by BT, 95 Sodium hyaluronate vs no sodium hyaluronate Over whole study period, vesical toxicity significantly lower for sodium hyaluronate No related adverse effects
(2.08% vs 12.8%; P < 0.05)
Prostaglandin
 Ippoliti et al. (1995) [58] Case series BMT patients with grade III or IV HC, 24 Prostaglandin F 62% had total response with doses ≥0.8 mg/dL 95.8% had bladder spasms
9 (37.5%) patients relapsed at median of 7 days
 Levine et al. (1993) [64] Case series BMT patients, 16 and patients with cancer, 2 with HC after CYC treatment Prostaglandin F 50% had complete reduction in gross haematuria 78.0% had bladder spasms
3 cases of recurrent haematuria
Formalin
 Lojanapiwat et al. (2002) [65] Case series Patients with pelvic malignancies and intractable haemorrhage secondary to RT-induced cystitis, 11 4% formalin 82% had complete response 4 major complications (e.g. anuria, fistula) and several minor (e.g. fever, tachycardia) complications
 Dewan et al. (1993) [66] Retrospective review Patients with cervical cancer with HC after RT, 35 1% formalin 89% had complete response and 8% partial response Major complications in 11%, with 5 requiring subsequent urinary diversion. Probable formalin toxicity in 1 patient
 Vicente et al. (1990) [67] Retrospective review Patients with HC after CYC or RT, 25 4% formalin 88% had good result 1 case of upper urinary tract dilatation
Alum irrigation
 Ho et al. (2009) [68] Case report Patient with ovarian cancer and HC after RT 1% alum Haematuria stopped after 24 h Well tolerated

CT, chemotherapy; CYC, cyclophosphamide; BT, brachytherapy; NS, not statistically significant;

*

Toxicity assessed using RTOG/EORTC Radiation Toxicity Score;

Complete response defined as the day when the symptoms improved.