Risk factors and dose-effects for bladder fistula, bleeding and cystitis after radiotherapy with imaged-guided adaptive brachytherapy for cervical cancer: An EMBRACE analysis

医学 近距离放射治疗 瘘管 泌尿科 宫颈癌 膀胱癌 危险系数 外科 放射治疗 内科学 癌症 置信区间
作者
Sofia Spampinato,Lars Fokdal,Richard Pötter,Christine Haie-Méder,Jacob Christian Lindegaard,Maximilian Schmid,Alina Sturdza,Ina M. Jürgenliemk‐Schulz,Umesh Mahantshetty,Barbara Šegedin,Kjersti Bruheim,Peter Hoskin,Bhavana Rai,Fleur Huang,Rachel Cooper,Elzbieta van der Steen-Banasik,Erik Van Limbergen,Marit Sundset,Henrike Westerveld,Remi A. Nout
出处
期刊:Radiotherapy and Oncology [Elsevier BV]
卷期号:158: 312-320 被引量:45
标识
DOI:10.1016/j.radonc.2021.01.019
摘要

To identify patient- and treatment-related risk factors for fistula, bleeding, cystitis, pain and difficulty in voiding in locally advanced cervical cancer patients treated with radio(chemo)therapy and image-guided adaptive brachytherapy (IGABT).Morbidity within the EMBRACE-I study was prospectively reported for physician-assessed (CTCAE) fistula, bleeding and cystitis and patient-reported (EORTC) pain and difficulty in voiding. Analysis of risk factors was performed in patients without bladder infiltration. Risk factors were tested with Cox regression for grade (G) ≥ 3 cystitis, for G ≥ 2 fistula, bleeding and cystitis, and for EORTC "very much" and "quite a bit" or worse.Of 1416 patients enrolled, 1153 and 884 patients without bladder infiltration were evaluable for the analysis of CTCAE and EORTC items, respectively. Median follow-up was 48[3-120] months. Crude incidence rates for G ≥ 2 fistula, bleeding and cystitis were 0.7%, 2.7% and 8.8%, respectively, and 16% and 14% for "quite a bit" or worse pain and difficulty in voiding, respectively. Baseline urinary morbidity and overweight/obesity were significant risk factors for most endpoints. Bladder D2cm3 correlated with G ≥ 2 fistula, bleeding and cystitis, while ICRU bladder point dose correlated with EORTC pain "quite a bit" or worse. An increase from 75 Gy to 80 Gy in bladder D2cm3 resulted in an increase from 8% to 13% for 4-year actuarial estimate of G ≥ 2 cystitis.Clinical and treatment-related risk factors for bladder fistula, bleeding and cystitis were identified within a prospective and multi-institutional setting. A dose-effect was established with bladder D2cm3, reinforcing the importance of continued optimization during individualized IGABT planning.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
三叶草完成签到,获得积分10
1秒前
奋斗的忆之完成签到,获得积分10
2秒前
彭于晏应助孤独的珩采纳,获得10
2秒前
2秒前
2秒前
3秒前
都是小儿卡通书完成签到,获得积分10
3秒前
3秒前
3秒前
YHF2完成签到,获得积分10
4秒前
satori完成签到,获得积分10
4秒前
充电宝应助luckzzz采纳,获得10
5秒前
零下负七完成签到,获得积分10
5秒前
英俊001完成签到 ,获得积分10
5秒前
leslie发布了新的文献求助10
6秒前
111发布了新的文献求助10
7秒前
海岸完成签到,获得积分20
7秒前
Orange应助优雅语兰采纳,获得10
7秒前
任性梦旋发布了新的文献求助10
7秒前
8秒前
zhang发布了新的文献求助10
9秒前
领导范儿应助Albertxkcj采纳,获得10
9秒前
10秒前
111完成签到,获得积分20
11秒前
海岸发布了新的文献求助10
11秒前
wsq完成签到 ,获得积分10
11秒前
11秒前
SciGPT应助畅快的涵蕾采纳,获得10
13秒前
乐乐应助小甲同学采纳,获得10
13秒前
佳佳应助山语采纳,获得10
14秒前
14秒前
小房子完成签到,获得积分10
15秒前
双shuang发布了新的文献求助10
16秒前
17秒前
孤独的珩发布了新的文献求助10
17秒前
bkagyin应助leslie采纳,获得10
19秒前
20秒前
keep发布了新的文献求助10
21秒前
单薄的白昼完成签到,获得积分10
21秒前
Albertxkcj发布了新的文献求助10
22秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3969884
求助须知:如何正确求助?哪些是违规求助? 3514604
关于积分的说明 11174901
捐赠科研通 3249928
什么是DOI,文献DOI怎么找? 1795149
邀请新用户注册赠送积分活动 875599
科研通“疑难数据库(出版商)”最低求助积分说明 804891