Журнал биоэквивалентности и биодоступности

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Use of Hyaluronic Acid (Cystistat) for the Treatment of Late Radiation Induced Cystitis in Patients after Prostate Irradiation

Kouloulias Vasssilis, Mosa Eftychia, Fotineas Andreas, Beli Ivelina, Asimakopoulos Charalampos, Chaldeopoulos Dimitrios, Kelekis Nikolaos, Chrysofos Michael and Siatelis Argyris

intravesical treatment for the radiation induced cystitis. Materials and Methods: Between September 2009 and December 2012, in a prospective way, 20 patients with prostate cancer that had showed radiation induced cystitis after radiotherapy, were selected for the present analysis and were treated with intravesical instillations of CYSTISTAT. All candidates had undergone three-dimensional confomal radiotherapy with a total dose of 72-74 Gy. They all suffered from radiation induced cystitis and painfull bladder syndrome and treated with 4 weekly bladder instillations of CYSTISTAT and 2 monthly instillations thereafter. Patients were started to be clinically evaluated 6 months post radiotherapy. Symptoms of haematuria, frequency of voiding and findings from cystoscopy were assessed before and 3 months after CYSTISTAT treatment, according the EORTC/RTOG criteria.

Results: The median age was 66 years. Treatment response was evaluated up to 20 months post radiotherapy. The patients were undergone cystoscopy before and after the CYSTISTAT treatment. All candidates completed the treatment scheme and no serious side effects of intravesical instillation of CYSTISTAT were recorded. A significant reduce of radiation induced cystitis was noted, since the mean score of radio-cystitis before and after the CYSTISTAT instillation was 2.70 ± 0.47 and 1.45 ± 0.51, respectively (P<0.01, Wilcoxon test). None of the patients presented any severe event during or after the CYSTISTAT instillation.

Conclusions: CYSTISTAT is a well-tolerated modality which achieves a significant decrease of bladder bleeding, pelvic pain and frequency of voiding.