Radiation Induced Cystitis Treated With Hyperbaric Oxygen - A Randomized Controlled Trial

NCT ID: NCT01659723

Last Updated: 2019-06-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-08-31

Study Completion Date

2018-08-09

Brief Summary

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The primary objective of this study is to assess the relief of symptoms after Hyperbaric Oxygen Therapy (HBOT) in patients with late radiation cystitis by having Expanded Prostate cancer Index Composite (EPIC)symptom estimation scale as primary variable.

Study hypothesis:

* HBOT can reduce or reverse the change or otherwise limit the damage of the bladder function and/or structure, which arose as a result of radiation therapy of cancer in the pelvic region organs.
* The effects of HBOT are associated with relief of symptoms that, at least in part, is related to the reduction of the extent of the radiation damage.
* Vascular density increases, fibrosis prevalence and inflammatory activity are reduced as a sign of an improved function of the mucosa.
* Treatment results of HBOT remains, in whole or in part, during the follow-up (residual effect)

Detailed Description

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Radiotherapy is commonly used in the management of malignant diseases. Despite a continuous improvement of the technique, with improved efficacy and tolerance, adverse effects are still rather common. The urinary bladder and rectum are the major organs most commonly affected by radiotherapy to the pelvis area.

One of the most significant causes of the symptoms of radio therapy is inflammation and degeneration of blood vessels in the radiated tissue. Hyperbaric oxygen therapy involves administration of oxygen at greater than normal atmospheric pressures. A well-documented effect of HBOT is the stimulation of angiogenesis. HBOT is an established treatment for degeneration of blood vessels in the jaw bone as a result of radiotherapy and several publications have shown good efficacy also when soft tissue is affected.

If the method of treatment with HBOT means a reduction of the radiotherapy side effect it is thus an obvious importance for the individual patient. There is also significant potential savings for the healthcare and society.

Conditions

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Cystitis, Radio Induced

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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A - Immediate start

Start of treatment within 6 weeks of inclusion in the study. 100% oxygen at 240-250 kPa will be delivered to the patents for 80-90 minutes while sitting or lying in a hyperbaric oxygen chamber. Patients will receive treatment once every day, except week-ends, for 40 days.

Group Type ACTIVE_COMPARATOR

Hyperbaric Oxygen

Intervention Type DRUG

100% oxygen at 240-250 kPa will be delivered to the patents for 80-90 minutes while sitting or lying in a hyperbaric oxygen chamber. Patients will receive treatment once every day, except week-ends, for 40 days.

B - delayed start

Delayed start: Start of treatment not before 6 months of inclusion in the study. No intervention is given during the initial period.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Hyperbaric Oxygen

100% oxygen at 240-250 kPa will be delivered to the patents for 80-90 minutes while sitting or lying in a hyperbaric oxygen chamber. Patients will receive treatment once every day, except week-ends, for 40 days.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Provision of informed consent prior to any study specific procedures
* Female or male aged 18-80 years
* Intended curative radiation of the pelvic region as a treatment for cancer
* End of radiation therapy more than 6 months ago
* Radiation cystitis with Urological EPIC \< 80
* Radiation cystitis is the most probable cause for the patient's symptoms

Exclusion Criteria

* Patients with major and ongoing bleedings from the bladder (requiring more than 0.5L blood-transfusion within the last four weeks)
* Refractory incontinence requiring catheter or surgical intervention
* Urine bladder capacity \< 100ml
* Fistula in the urine bladder
* Contraindications for HBOT according to the local centres routines
* Pregnancy
* Mechanical ventilator support
* Unable to follow and understand simple commands
* Not oriented to person, place and time
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Göteborg University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nicklas Oscarsson, MD

Role: PRINCIPAL_INVESTIGATOR

Sahlgrenska, Gothenburg University

Locations

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Rigshospitalet Copenhagen

Copenhagen, , Denmark

Site Status

Turku Hospital

Turku, , Finland

Site Status

Haukeland Universitetssykehus

Bergen, , Norway

Site Status

Shalgrenska University Hospial

Gothenburg, , Sweden

Site Status

Karolinska University Hospital

Stockholm, , Sweden

Site Status

Countries

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Denmark Finland Norway Sweden

References

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Oscarsson N, Rosen A, Muller B, Koskela LR, Giglio D, Kjellberg A, Ettala O, Seeman-Lodding H. Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): long-term follow-up of a randomised controlled, phase 2-3 trial. EClinicalMedicine. 2025 Apr 19;83:103214. doi: 10.1016/j.eclinm.2025.103214. eCollection 2025 May.

Reference Type DERIVED
PMID: 40291346 (View on PubMed)

Oscarsson N, Muller B, Rosen A, Lodding P, Molne J, Giglio D, Hjelle KM, Vaagbo G, Hyldegaard O, Vangedal M, Salling L, Kjellberg A, Lind F, Ettala O, Arola O, Seeman-Lodding H. Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2-3 trial. Lancet Oncol. 2019 Nov;20(11):1602-1614. doi: 10.1016/S1470-2045(19)30494-2. Epub 2019 Sep 16.

Reference Type DERIVED
PMID: 31537473 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Document Type: Study Protocol and Informed Consent Form

View Document

Other Identifiers

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2012-001381-15

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

RICH-ART 2012-001381-15

Identifier Type: -

Identifier Source: org_study_id

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