Erschienen in:
01.07.2013 | Original article
Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer
verfasst von:
Dr. P. Georg, MD, A. Boni, MD, A. Ghabuous, MD, G. Goldner, MD, M.P. Schmid, MD, D. Georg, PhD, R. Pötter, MD, W. Dörr, DVM, PhD
Erschienen in:
Strahlentherapie und Onkologie
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Ausgabe 7/2013
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Abstract
Background and purpose
To analyze the time course of late rectal- and urinary bladder complications after brachytherapy for cervical cancer and to compare the incidence- and prevalence rates thereof.
Patients and methods
A total of 225 patients were treated with external-beam radiotherapy (EBRT) and magnetic resonance imaging (MRI)-guided brachytherapy with or without chemotherapy. Late side effects were assessed prospectively using the Late Effects in Normal Tissue—Subjective, Objective, Management and Analytic (LENT/SOMA) scale. The parameters analyzed were time to onset, duration, actuarial incidence- (occurrence of new side effects during a defined time period) and prevalence rates (side effects existing at a defined time point).
Results
Median follow-up was 44 months. Side effects (grade 1–4) in rectum and bladder were present in 31 and 49 patients, 14 and 27 months (mean time to onset) after treatment, respectively. All rectal and 76 % of bladder side effects occurred within 3 years after radiotherapy. Mean duration of rectal events was 19 months; 81 % resolved within 3 years of their initial diagnosis. Mean duration of bladder side effects was 20 months; 61 % resolved within 3 years. The 3- and 5-year actuarial complication rates were 16 and 19 % in rectum and 18 and 28 % in bladder, respectively. The corresponding prevalence rates were 9 and 2 % (rectum) and 18 and 21 % (bladder), respectively.
Conclusion
Late side effects after cervical cancer radiotherapy are partially reversible, but their time course is organ-dependent. The combined presentation of incidence- and prevalence rates provides the most comprehensive information.