Importance of the ICRU bladder point dose on incidence and persistence of urinary frequency and incontinence in locally advanced cervical cancer: An EMBRACE analysis
| Autor: | Erik Van Limbergen, Christine Haie-Meder, Elzbieta van der Steen-Banasik, Alina Sturdza, Barbara Segedin, Nina Boje Kibsgaard Jensen, Richard Pötter, Jacob Christian Lindegaard, Henrike Westerveld, Christian Kirisits, Kari Tanderup, Ina M. Jürgenliemk-Schulz, Umesh Mahantshetty, Kathrin Kirchheiner, Rachel Cooper, Remi A. Nout, Bhavana Rai, Kjersti Bruheim, Fleur Huang, Marit Sundset, Lars Fokdal, Peter Hoskin, Sofia Spampinato, Maximilian Schmid |
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| Přispěvatelé: | Radiotherapy, CCA - Cancer Treatment and Quality of Life |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urinary morbidity medicine.medical_treatment Urinary system Brachytherapy Urinary Bladder Urology Uterine Cervical Neoplasms Urinary incontinence 030218 nuclear medicine & medical imaging Clinical study 03 medical and health sciences 0302 clinical medicine medicine Humans IGABT Radiology Nuclear Medicine and imaging Risk factor Radiation treatment planning Aged Dose-effect relationship Cervical cancer Proportional hazards model business.industry Incidence Incidence (epidemiology) Rectum Radiotherapy Dosage Hematology medicine.disease Urinary Incontinence Risk factors Oncology 030220 oncology & carcinogenesis Female medicine.symptom business |
| Zdroj: | Spampinato, S, Fokdal, L U, Pötter, R, Haie-Meder, C, Lindegaard, J C, Schmid, M P, Sturdza, A, Jürgenliemk-Schulz, I M, Mahantshetty, U, Segedin, B, Bruheim, K, Hoskin, P, Rai, B, Huang, F, Cooper, R, van der Steen-Banasik, E, Van Limbergen, E, Sundset, M, Westerveld, H, Nout, R A, Jensen, N B K, Kirisits, C, Kirchheiner, K, Tanderup, K & EMBRACE Collaborative Group1 2021, ' Importance of the ICRU bladder point dose on incidence and persistence of urinary frequency and incontinence in locally advanced cervical cancer : An EMBRACE analysis ', Radiotherapy and Oncology, vol. 158, pp. 300-308 . https://doi.org/10.1016/j.radonc.2020.10.003 Radiotherapy and oncology, 158, 300-308. Elsevier Ireland Ltd |
| ISSN: | 0167-8140 |
| Popis: | Purpose: To identify patient- and treatment-related risk factors and dose-effects for urinary frequency and incontinence in locally advanced cervical cancer (LACC) treated with radio(chemo)therapy and image-guided adaptive brachytherapy (IGABT). Material and methods: Physician-assessed (CTCAE) and patient-reported (EORTC) frequency and incontinence recorded in the EMBRACE-I study were analysed. Risk factors analysis was performed in patients without bladder infiltration and with baseline morbidity available. Cox regression was used for CTCAE grade (G) ≥ 3 and G ≥ 2 and for EORTC “very much” and “quite a bit” or worse. Logistic regression was used for late persistent morbidity defined when CTCAE G ≥ 1 or EORTC ≥ “quite a bit” were scored in at least half of follow-ups. Results: Longitudinal data on 1153 and 884 patients were available for CTCAE and EORTC analysis, respectively. Median follow-up was 48[3-120] months. Crude incidence rates of G≥2 were 13% and 11% for frequency and incontinence, respectively. Baseline morbidity and overweight-obesity were risk factors for both symptoms. Elderly patients were at higher risk for incontinence. Patients receiving conformal-radiotherapy were at higher risk for frequency. ICRU bladder point (ICRU-BP) dose was a stronger predictor for incontinence than bladder D2cm3. The 5-year actuarial estimate of G ≥ 2 incontinence increased from 11% to 20% with ICRU-BP doses > 75 Gy compared to ≤ 65 Gy. Frequency showed weaker associations with dose. Conclusion: ICRU-BP dose, in addition to clinical parameters, is a risk factor for urinary incontinence and shows a dose–effect after radio(chemo)therapy and IGABT. ICRU-BP dose should be monitored during treatment planning alongside volumetric parameters. Frequency seems associated with larger irradiated volumes. |
| Databáze: | OpenAIRE |
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