Incidence and Morbidity of Radiation-Induced Hemorrhagic Cystitis in Prostate Cancer
Incidence and Morbidity of Radiation-Induced Hemorrhagic Cystitis in Prostate Cancer
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DOI：
10.1016/j.urology.2019.05.034
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发表时间：
2019-09-01
期刊：
影响因子：
2.1
通讯作者：
Abdelhady, Mazen
中科院分区：
文献类型：
--
作者：
Martin, Sarah E.;Begun, Evan M.;Abdelhady, Mazen
目的确定前列腺癌放射治疗后出血性膀胱炎的报告发病率是否准确，材料与方法对底特律医学中心2所医院的709例前列腺癌患者进行了回顾性病历分析，这些患者在1月至12月期间接受了放射治疗。2000年和2015年9月。在发生出血性膀胱炎的患者中，我们分析了其发病率、放射方式、发病率、治疗和并发症。外照射和调强放疗与出血性膀胱炎的发生率无显著差异（P = 0.18）。患者在放疗后平均79.1个月（4-230个月）发生出血性膀胱炎。平均入院人数为2.5（1-9），平均住院时间为7.6天（1-42天）。52%的患者需要输血，平均每例患者输血4.3单位（1- 33 U）。最常见的治疗是膀胱镜检查和电灼/凝块排空，86%的患者接受了该治疗。并发症包括尿路感染，急性肾损伤，尿脓毒症，甚至死亡。结论出血性膀胱炎的发病率以下的前列腺癌放射治疗的文献报道。出血性膀胱炎与患者的高发病率和并发症相关，需要多次住院、输血和手术。放射治疗的进步并没有显著降低出血性膀胱炎的风险。(C)2019爱思唯尔公司
OBJECTIVE To determine if reported incidence rates of hemorrhagic cystitis after radiation therapy for prostate cancer are accurate, to investigate the effect of different radiation modalities on the development of hemorrhagic cystitis and to assess its morbidity and treatment.MATERIALS AND METHODS A retrospective chart review was completed of 709 patients at 2 Detroit Medical Center hospitals who underwent radiation therapy for prostate cancer between January 2000 and September 2015. In patients who developed hemorrhagic cystitis, we analyzed the incidence, radiation modality, morbidity, treatment, and complications.RESULTS The incidence rate of hemorrhagic cystitis after radiation for prostate cancer was 11.1%. There was no significant difference between external beam and intensity-modulated radiation therapy and the development of hemorrhagic cystitis (P = .18). Patients developed hemorrhagic cystitis an average of 79.1 months (4-230 months) after radiation. The average number of admissions was 2.5 (1-9) with an average length of stay of 7.6 days (1-42 days). Fifty-two percent of patients required blood transfusion with an average of 4.3 units transfused per patient (1-33U). The most common treatment was cystoscopy with fulguration/clot evacuation in 86% of patients. Complications included urinary tract infection, acute kidney injury, urosepsis, and even death.CONCLUSION The incidence of hemorrhagic cystitis following radiation therapy for prostate cancer is under-reported in the literature. Hemorrhagic cystitis is associated with high morbidity and complications for patients, requiring multiple hospitalizations, blood transfusions, and procedures. Advances in radiation have not significantly reduced the risk of developing hemorrhagic cystitis. (C) 2019 Elsevier Inc.