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Indications Cystitis after radiotherapy for prostatic cancer PowerPoint PPT Presentation


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Efficacy of sodium hyaluronate in the management of chemical and radiation cystitis Sommariva et al. Minerrva Urol Nefrol 2010. Indications Cystitis after radiotherapy for prostatic cancer

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Indications Cystitis after radiotherapy for prostatic cancer

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Indications cystitis after radiotherapy for prostatic cancer

Efficacy of sodiumhyaluronate in themanagement of chemical and radiationcystitisSommariva et al.

MinerrvaUrolNefrol 2010


Indications cystitis after radiotherapy for prostatic cancer

Indications

  • Cystitisafterradiotherapyforprostaticcancer

  • Cystitis in patientsreceivinginmuno-chemotherapeuticagentsbyintravesicalinjstillationfor non-muscleinvasivetransitionalcell carcinoma of thebladder (BCG orMitomycin C)

    Poor and Slow response tothe usual symptomatictreatments

    Thesebladdersymptomsoften mean thatcancertherapy has tobeinterrupted, which has furtherclinicalimplications, liketheimpactonthepossibility of success


Indications cystitis after radiotherapy for prostatic cancer

Administration of Cystistat

  • 69 maleconsecutivepatients

  • 15 afterRadiotherapy (Rxt)

  • 24 after BCG

  • 30afterMitomycin C


Indications cystitis after radiotherapy for prostatic cancer

Administration of Cystistat

  • Cystistatwasadministeredweeklyfrom 8 to 24 weeks, dependingonhowthyesymptomsreleased.

  • Lidocaine 2% 30 mLwasinstilled 30 min before, toallowpatientstokeepCystistatwithinthebladder

  • In thefirst 4 weeks, Dexamethasone 32 mg wasmixedto HA lookingforanantiinflammatoryeffect


Indications cystitis after radiotherapy for prostatic cancer

Results

  • – BladderCapacity (BC)

  • – Visual Analogic Score (VAS) forPain

  • Afteronly 4 weeks BC increased in allpatients, and Urgency and Painalmostdisappeared. Treatmentwascontinuedhoweverforanother 4 weeks, even in patientswith total remission of theirsymptoms.

  • Itwasseenpreviouslybytheauthorsthatiftherapystoppedtosoon, thenthesymptomscouldreturn.


Indications cystitis after radiotherapy for prostatic cancer

ChemicalCystitisgroupRIC groupBTATBTAT

VAS 8,6 0,9 NotMeasured

  • (Frequency + Urgency)

  • BC BTATBTAT

  • 58,4 283,7 85,0243,3


Indications cystitis after radiotherapy for prostatic cancer

  • 97% reported complete relief of dysuria and pain

  • No adversereactions, allowingtheconclusion of treatmentsforbladdercancer

  • Aftertherapy, urinarycitology and cistoscopyruledoutbledderrcancerprogression

  • Conclusion:

  • IntravesicalHyaluronan (HA) seems a valid and quicktherapeuticsolutionforiatrogeniccystitisfromchemoorradiotherapy


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