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Risk factors and dose-effects for bladder fistula, bleeding and cystitis after radiotherapy with imaged-guided adaptive brachytherapy for cervical cancer : an EMBRACE analysisSpampinato, Sofia ...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 G%3 cystitis, for G%2 fistula, bleeding and cystitis, and for EORTC "very much" and "quite a bit" or worse. Results: 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 75Gy to 80Gy in bladder D2cm3 resulted in an increase from 8% to 13% for 4-year actuarial estimate of G%2 cystitis. Conclusion: 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.Vir: Radiotherapy and oncology. - ISSN 0167-8140 (Vol. 158, 2021, str. 312-320)Vrsta gradiva - članek, sestavni delLeto - 2021Jezik - angleškiCOBISS.SI-ID - 51332867
Avtor
Spampinato, Sofia |
Fokdal, Lars U. |
Pötter, Richard |
Haie-Meder, Christine |
Lindegaard, Jacob Christian |
Schmid, Maximilian, radioterapevt |
Sturdza, Alina |
Jürgenliemk-Schulz, Ina Maria |
Mahantshetty, Umesh |
Šegedin, Barbara
Teme
rak materničnega vratu |
radioterapija |
brahiterapija |
slikovno vodena brahiterapija |
cervical cancer |
radiotherapy |
brachytherapy |
imaged-guided adaptive brachytherapy
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Spampinato, Sofia | ![]() |
Fokdal, Lars U. | ![]() |
Pötter, Richard | ![]() |
Haie-Meder, Christine | ![]() |
Lindegaard, Jacob Christian | ![]() |
Schmid, Maximilian, radioterapevt | ![]() |
Sturdza, Alina | ![]() |
Jürgenliemk-Schulz, Ina Maria | ![]() |
Mahantshetty, Umesh | ![]() |
Šegedin, Barbara | 27754 |
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