Introduction: Radiotherapies (RT) are considered as the second major therapeutic modalities for localized high-risk prostate cancers. Conformal postoperative radiotherapy in patients with positive resection margins and/or pT3-4 prostate adenocarcinoma is the routine approach. Nevertheless, the proximity of the rectum and bladder is a limiting factor in the safe delivery of dose-escalated RT. Urinary toxicity has a major impact on the post-treatment quality of life of patients who have undergone postoperative RT. The standard therapy of severe radiation cystitis consists in the intravesical administration of hyaluronic acid, a long treatment, not simple for the use of the catheter and extremely suffering for patients. Based on this scientific background, we conducted a non-randomized controlled study to evaluate the impact of oral administration of low molecular weight hyaluronic acid (LMW-HA) as preventive treatment for RT-induced toxicity.
Patients and Methods: A total of 42 patients aged between 55-87 years who underwent RT after prostatectomy, were included in our study. Eighteen patients received 1 tablet of LMW-HA twice a day 1-month before and for all duration of RT; the other 24 patients underwent standard-RT protocol.
Results: Only two people in treated group developed toxicity (11.11%), whereas all patients in control group developed toxicity during RT (100%) (p ≤ 0.0001). Moreover, after appearance of toxicity, 5 patients from the control group started the treatment with LMW-HA removing completely toxicity.
Conclusions: In 89% of cases enrolled in the experimental arm, the appearance of acute toxicity during RT was prevented, improving their quality of life. Therefore, oral LMW-HA can be considered an alternative approach in preventing and/or reducing cystitis symptoms in patients undergoing RT.