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Published in: Supportive Care in Cancer 5/2014

01-05-2014 | Original Article

Intravesical instillations with polydeoxyribonucleotides reduce symptoms of radiation-induced cystitis in patients treated with radiotherapy for pelvic cancer: a pilot study

Authors: Pierluigi Bonfili, Pietro Franzese, Francesco Marampon, Maria Emilia La Verghetta, Silvia Parente, Manuela Cerasani, Daniela Di Genova, Marta Mancini, Francesca Vittorini, Giovanni Luca Gravina, Valeria Ruggieri, Mario Di Staso, Vladimir M. Popov, Vincenzo Tombolini, Ernesto Di Cesare

Published in: Supportive Care in Cancer | Issue 5/2014

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Abstract

Purpose

Chronic radiation cystitis (CRC) is a serious complication that can arise in patients with pelvic malignancies treated with radiotherapy. Polydeoxyribonucleotides (PDRNs) are known to reduce inflammation and improve tissue perfusion and angiogenesis. In this manuscript, we describe our observational experience regarding intravesical instillation of PDRNs in improving symptoms of CRC in subjects unresponsiveness to conventional medical therapy.

Methods

Eight patients with persistent and/or worsening CRC symptoms, despite conventional therapy, received biweekly intravesical instillation of PDRNs for two consecutive months. Symptoms were scored according to the Late Effects of Normal Tissues-Subjective, Objective, Management, Analytic (LENT-SOMA) scale, before, at the end, and after 4 months following the PDRNs treatment.

Results

Four months after instillations, a significant improvement in the subjective perception of CRC symptoms was experienced by participants. The mean LENT-SOMA score was reduced from 1.16 + 0.26 before to 0.34 + 0.035 after 4 months from instillations (p < 0.001). No adverse effect related to instillations was reported.

Conclusions

Subjective perception of persistent and/or worsening CRC symptoms, despite conventional therapy, is improved after intravesical instillation with PDRNs without adverse events. Even though we deduced suggestive insights, the results need to be collected and verified from a large-scale study.
Literature
2.
go back to reference Marks LB, Carroll PR, Dugan TC et al (1995) The response of the urinary bladder, urethra, and ureter to radiation and chemotherapy. Int J Radiat Oncol Biol Phys 31:1257PubMedCrossRef Marks LB, Carroll PR, Dugan TC et al (1995) The response of the urinary bladder, urethra, and ureter to radiation and chemotherapy. Int J Radiat Oncol Biol Phys 31:1257PubMedCrossRef
3.
go back to reference Magrina JF (1993) Urologic complications of radiation therapy for gynecologic malignancies. Int Urogynecol J Pelvic Floor Dysfunct 4:111CrossRef Magrina JF (1993) Urologic complications of radiation therapy for gynecologic malignancies. Int Urogynecol J Pelvic Floor Dysfunct 4:111CrossRef
4.
5.
go back to reference Madersbacher H, van Ophoven A, van Kerrebroeck PE (2013) GAG layer replenishment therapy for chronic forms of cystitis with intravesical glycosaminoglycans—a review. Neurourol Urodyn 32:9–18PubMedCrossRef Madersbacher H, van Ophoven A, van Kerrebroeck PE (2013) GAG layer replenishment therapy for chronic forms of cystitis with intravesical glycosaminoglycans—a review. Neurourol Urodyn 32:9–18PubMedCrossRef
7.
go back to reference Gomez G, Sitkovsky MV (2003) Targeting G protein-coupled A2a adenosine receptors to engineer inflammation in vivo. Int J Biochem Cell Biol 35:410–414PubMedCrossRef Gomez G, Sitkovsky MV (2003) Targeting G protein-coupled A2a adenosine receptors to engineer inflammation in vivo. Int J Biochem Cell Biol 35:410–414PubMedCrossRef
8.
go back to reference Altavilla D, Bitto A, Polito F et al (2009) Polydeoxyribonucleotide (PDRN): a safe approach to induce therapeutic angiogenesis in peripheral artery occlusive disease and in diabetic foot ulcers. Cardiovasc Hematol Agents Med Chem 7:313–321PubMedCrossRef Altavilla D, Bitto A, Polito F et al (2009) Polydeoxyribonucleotide (PDRN): a safe approach to induce therapeutic angiogenesis in peripheral artery occlusive disease and in diabetic foot ulcers. Cardiovasc Hematol Agents Med Chem 7:313–321PubMedCrossRef
9.
go back to reference Tonello G, Daglio M, Zaccarelli N et al (1996) Characterization and quantitation of the active polynucleotide fraction (PDRN) from human placenta, a tissue repair stimulating agent. J Pharm Biomed Anal 14:1555–1560PubMedCrossRef Tonello G, Daglio M, Zaccarelli N et al (1996) Characterization and quantitation of the active polynucleotide fraction (PDRN) from human placenta, a tissue repair stimulating agent. J Pharm Biomed Anal 14:1555–1560PubMedCrossRef
10.
go back to reference Bitto A, Polito F, Irrera N et al (2011) Polydeoxyribonucleotide reduces cytokine production and the severity of collagen-induced arthritis by stimulation of adenosine A2A receptor. Arthritis Rheum 63:3364–3371PubMedCrossRef Bitto A, Polito F, Irrera N et al (2011) Polydeoxyribonucleotide reduces cytokine production and the severity of collagen-induced arthritis by stimulation of adenosine A2A receptor. Arthritis Rheum 63:3364–3371PubMedCrossRef
11.
go back to reference Polito F, Bitto A, Galeano M et al (2012) Polydeoxyribonucleotide restores blood flow in an experimental model of ischemic skin flaps. J Vasc Surg 55:479–488PubMedCrossRef Polito F, Bitto A, Galeano M et al (2012) Polydeoxyribonucleotide restores blood flow in an experimental model of ischemic skin flaps. J Vasc Surg 55:479–488PubMedCrossRef
12.
go back to reference Alessandra B, Mariarosaria G, Squadrito F et al (2008) Polydeoxyribonucleotide improves angiogenesis and wound healing in experimental thermal injury. Crit Care Med 36:1594–1602CrossRef Alessandra B, Mariarosaria G, Squadrito F et al (2008) Polydeoxyribonucleotide improves angiogenesis and wound healing in experimental thermal injury. Crit Care Med 36:1594–1602CrossRef
13.
go back to reference Berkey FJ (2010) Managing the adverse effects of radiation therapy. Am Fam Physician 82:381–388, 394PubMed Berkey FJ (2010) Managing the adverse effects of radiation therapy. Am Fam Physician 82:381–388, 394PubMed
14.
go back to reference Denton AS, Clarke NW, Maher EJ (2002) Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis. Cochrane Database Syst Rev 3, CD001773PubMed Denton AS, Clarke NW, Maher EJ (2002) Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis. Cochrane Database Syst Rev 3, CD001773PubMed
15.
go back to reference (1995) LENT SOMA scales for all anatomic sites. Int J Radiat Oncol Biol Phys 31(5):1049–1091 (1995) LENT SOMA scales for all anatomic sites. Int J Radiat Oncol Biol Phys 31(5):1049–1091
16.
go back to reference Tombolini V, Di Staso M, Bonfili P et al (2010) Subjective and objective measures of late genitourinary morbidity following hypofractionated radiotherapy in men with prostate cancer. Prostate Cancer Prostatic Dis 13:34–38PubMedCrossRef Tombolini V, Di Staso M, Bonfili P et al (2010) Subjective and objective measures of late genitourinary morbidity following hypofractionated radiotherapy in men with prostate cancer. Prostate Cancer Prostatic Dis 13:34–38PubMedCrossRef
Metadata
Title
Intravesical instillations with polydeoxyribonucleotides reduce symptoms of radiation-induced cystitis in patients treated with radiotherapy for pelvic cancer: a pilot study
Authors
Pierluigi Bonfili
Pietro Franzese
Francesco Marampon
Maria Emilia La Verghetta
Silvia Parente
Manuela Cerasani
Daniela Di Genova
Marta Mancini
Francesca Vittorini
Giovanni Luca Gravina
Valeria Ruggieri
Mario Di Staso
Vladimir M. Popov
Vincenzo Tombolini
Ernesto Di Cesare
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 5/2014
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-013-2051-9

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