A prospective survey study of lower urinary tract dysfunction in childhood cancer survivors after vincristine and/or doxorubicin chemotherapy.
A prospective survey study of lower urinary tract dysfunction in childhood cancer survivors after vincristine and/or doxorubicin chemotherapy.
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DOI：
10.1002/pbc.29226
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发表时间：
2021-10
影响因子：
3.2
通讯作者：
Cost NG
中科院分区：
文献类型：
--
作者：
Hecht SL;Quach A;Gao D;Brazell A;Beltran G;Holbrook S;Gore L;Iguchi N;Malykhina A;Wilcox D;Cost NG
长春新碱（VCR）和阿霉素（DOX）是儿科肿瘤学中广泛使用的两种化疗药物，它们分别可引起神经病变和肌病。研究假设VCR的神经毒性作用和/或DOX的肌肉毒性作用影响膀胱生理学，临床表现为下尿路功能障碍（LUTD）。根据先验功效分析，招募了161名儿童，按性别平均分配。5-10岁的儿童完成了排尿功能障碍评分系统（DVSS）调查。研究队列包括接受VCR和/或DOX治疗的癌症存活者。健康对照组是从健康儿童诊所招募的。排除标准包括盆腔恶性肿瘤、盆腔放疗、既存LUTD、神经系统异常和环磷酰胺/异环磷酰胺治疗。比较了各队列的DVSS评分和LUTD（定义为DVSS评分高于性别特异性阈值（男性≥9，女性≥6））。研究队列的中位DVSS评分较高（6 vs 4，p=0.003）。此外，研究队列中的儿童更有可能超过LUTD的阈值评分（38.8% vs 21%，p=0.014; OR 1.8）。按性别进行的亚组分析显示，女性癌症幸存者比对照组更有可能报告LUTD（57.5% vs 30%，p=0.013，OR 1.9）。男性的情况并非如此（20% vs 12.2%，p=0.339）。接受VCR和/或DOX治疗的儿童癌症幸存者报告的LUTD发生率高于对照组。女性癌症幸存者似乎比男性更容易患LUTD。正在对接受非VCR、非DOX化疗的癌症幸存者的阳性对照队列进行进一步研究，以阐明癌症诊断对LUTD的贡献。
Two chemotherapeutic agents used widely in pediatric oncology are vincristine (VCR) and doxorubicin (DOX), which may cause neuropathy and myopathy, respectively. The study hypothesis is that neurotoxic effects of VCR and/or myotoxic effects of DOX affect bladder physiology and manifest clinically as lower urinary tract dysfunction (LUTD). Based on a priori power analysis, 161 children divided evenly by gender were recruited. Children aged 5–10 years completed the dysfunctional voiding scoring system (DVSS) survey. The study cohort comprised cancer survivors treated with VCR and/or DOX. Healthy controls were recruited from well-child clinic visits. Exclusion criteria included pelvic-based malignancy, pelvic irradiation, pre-existing LUTD, neurologic abnormalities, and treatment with cyclophosphamide/ifosfamide. DVSS scores and presence of LUTD, defined as DVSS scores above gender-specific thresholds (males≥9, females≥6), were compared across cohorts. Median DVSS scores were higher in the study cohort (6 vs 4, p=0.003). Moreover, children in the study cohort were more likely to exceed threshold scores for LUTD (38.8% vs 21%, p=0.014; OR 1.8). Sub-analysis by gender revealed female cancer survivors are more likely to report LUTD than controls (57.5% vs 30%, p=0.013, OR 1.9). This did not hold true for males (20% vs 12.2%, p=0.339). Childhood cancer survivors who received VCR and/or DOX reported higher rates of LUTD than controls. Female cancer survivors appear more likely to suffer from LUTD than males. Further study with a positive control cohort of cancer survivors who received non-VCR, non-DOX chemotherapy is underway to elucidate the contribution of a cancer diagnosis to LUTD.
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影响因子：
2.1
作者：
Hu, TW;Wagner, TH;Hunt, T
通讯作者：
Hunt, T
DOI：
10.1007/s11764-011-0192-8
发表时间：
2011-12
期刊：
Journal of cancer survivorship : research and practice
影响因子：
--
作者：
Eshelman-Kent D;Kinahan KE;Hobbie W;Landier W;Teal S;Friedman D;Nagarajan R;Freyer DR
通讯作者：
Freyer DR
影响因子：
1.2
作者：
Pashankar, Farzana D.;Season, J. Hale;Pashankar, Dinesh S.
通讯作者：
Pashankar, Dinesh S.
影响因子：
6.6
作者：
Combs, Andrew J.;Van Batavia, Jason P.;Glassberg, Kenneth I.
通讯作者：
Glassberg, Kenneth I.
影响因子：
3.8
作者：
Gladh, Gunilla;Eldh, Monica;Mattsson, Sven
通讯作者：
Mattsson, Sven