| Li Fenghu,Mei Fan,Du Yanjun,Tian Xue,Hu Lili,Hong Wei,Ban Hong,Yin Shuishui,Hu Yinxiang,Lu Bing,Li Jiehui.Correlations of irradiation dose to urethra with urinary complications in concurrent chemoradiotherapy for locally advanced cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2024,44(1):18-23 |
| Correlations of irradiation dose to urethra with urinary complications in concurrent chemoradiotherapy for locally advanced cervical cancer |
| Received:May 24, 2023 |
| DOI：10.3760/cma.j.cn112271-20230524-00159 |
| KeyWords:Cervical cancer Pelvic radiotherapy Adverse reaction Urinary |
| FundProject:贵州省抗癌协会科技计划项目(014[2023]) |
| Author Name | Affiliation | E-mail | | Li Fenghu | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Mei Fan | Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Du Yanjun | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Tian Xue | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Hu Lili | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Hong Wei | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Ban Hong | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Yin Shuishui | Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Hu Yinxiang | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Lu Bing | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | | | Li Jiehui | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Department of Gynecological Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550004, China | 512111848@qq.com |
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| Abstract:: |
| Objective To investigate the correlations of urinary adverse reactions with dose to the bladder and urethra during external pelvic irradiation for locally advanced cervical cancer. Methods This study retrospectively collected relevant dosimetric parameters and urinary symptoms, such as frequent, urgent, and painful urination, from locally advanced cervical cancer patients treated with external pelvic irradiation in the Department of Oncology, Affiliated Hospital of Guizhou Medical University. The dosimetric parameters examined in this study included the maximum, minimum, and mean doses to bladder and urethra (i.e., Dmax, Dmin and Dmean), mean doses received in an area of 0.1, 1, and 2 cm3 around the planning target volume, D0.1 cm3, D1 cm3, D2 cm3, and percentages of irradiated volumes in the whole organ volume under doses of 5, 10, 15, 20, 25, 30, 35, 40, 45, 50 Gy, V5 Gy, V10 Gy, V15 Gy, V20 Gy, V25 Gy, V30 Gy, V35 Gy, V40 Gy, V45 Gy, V50 Gy. Then the correlations between urinary symptoms and these dosimetric parameters were analyzed using the independent-sample t-test and the Logistic regression model. Results The median volumes of bladder and urethra were 294.8 and 4.71 cm3, respectively. Patients were divided into two groups based on the median division. The univariate analysis showed that urethral Dmax, Dmin, Dmean, V5 Gy, V10 Gy, V15Gy, V20 Gy, V25 Gy, V30 Gy, V35 Gy, V40 Gy, V45 Gy and V50 Gy correlated with urinary complications (t = 14.30, 21.65, 32.19, 33.36, 16.62, 17.91, 21.52, 20.11, 12.27, 37.25, 30.18, 36.24 and 21.98, P＜0.05). The multivariate analysis further indicates that urethral D2 cm3, V20 Gy, V40 Gy and Bladder V40 Gy, D1 cm3, D2 cm3 were independent predictors of grade 2 urinary adverse reactions (P＜0.05). Conclusions This study reported the correlations of relevant dosimetric parameters of urethra with urinary toxicity during external pelvic irradiation. It holds that urethral D2 cm3, V20 Gy and V40 Gy should be restricted to minimize the risks of grade 2 urinary complications. |
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