Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical Cancer
ObjectiveThe study aims to investigate if a relationship exists between vaginal doses and vaginal stenosis (VS) using posterior–inferior border of symphysis (PIBS) points and the International Commission on Radiation Units-Rectum (ICRU-R) point evaluation system for definitive radio(chemo)therapy in...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-04-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.840144/full |
| _version_ | 1828311511689330688 |
|---|---|
| author | Juan Wang Kai-shuo Zhang Zi Liu Tao Wang Rui-hua Wang Fu-quan Zhang Lang Yu Ya-li Wang Li-chun Wei Mei Shi Sha Li Bao-gang Liu Fan Shi Jin Su Wei Yuan Qi ying Zhang Jing Zhang |
| author_facet | Juan Wang Kai-shuo Zhang Zi Liu Tao Wang Rui-hua Wang Fu-quan Zhang Lang Yu Ya-li Wang Li-chun Wei Mei Shi Sha Li Bao-gang Liu Fan Shi Jin Su Wei Yuan Qi ying Zhang Jing Zhang |
| author_sort | Juan Wang |
| collection | DOAJ |
| description | ObjectiveThe study aims to investigate if a relationship exists between vaginal doses and vaginal stenosis (VS) using posterior–inferior border of symphysis (PIBS) points and the International Commission on Radiation Units-Rectum (ICRU-R) point evaluation system for definitive radio(chemo)therapy in locally advanced cervical cancer.Methods and MaterialsFrom a vaginal dose study in China, 351 patients were prospectively assessed. For every reference point of the PIBS system and ICRU-R point was calculated for all BT and summed with EBRT. Pearson’s chi-square test and Student’s unpaired t-test compared variables with and without vaginal stenosis (VS) G ≥2. The risk factors were assessed for VS G ≥2 in multi- and univariate analyses through Cox proportional hazards model followed by a dose–effect curve construction. The VS morbidity rate was compared via the log-rank test using the median vaginal reference length (VRL).ResultsThe patients (38-month median follow-up) had 21.3% three-year actuarial estimate for VS G ≥2. Compared to G <2 patients, VS G ≥2 patients received higher doses to PIBS points except for PIBS − 2 and had significantly shorter VRL. VRL (HR = 1.765, P = 0.038), total EBRT and BT ICRU-R point dose (HR = 1.017, p = 0.003) were risk factors for VS. With VRL >4.6 cm, the 3-year actuarial estimate was 12.8% vs. 29.6% for VRL ≤4.6 cm. According to the model curve, the risks were 21, 30, and 39% at 75, 85, and 95 Gy, respectively (ICRU-R point dose).ConclusionsPIBS system point doses correlated with late vaginal toxicity. VRL combined with both EBRT and BT dose to the ICRU-R point contribute to VS risk. |
| first_indexed | 2024-04-13T16:00:12Z |
| format | Article |
| id | doaj.art-f4eca7308ba241a480da8ea462a0b2c6 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T16:00:12Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-f4eca7308ba241a480da8ea462a0b2c62022-12-22T02:40:34ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-04-011210.3389/fonc.2022.840144840144Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical CancerJuan Wang0Kai-shuo Zhang1Zi Liu2Tao Wang3Rui-hua Wang4Fu-quan Zhang5Lang Yu6Ya-li Wang7Li-chun Wei8Mei Shi9Sha Li10Bao-gang Liu11Fan Shi12Jin Su13Wei Yuan14Qi ying Zhang15Jing Zhang16Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, Hanzhong Center Hospital, Hanzhong, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, The Second Affiliated hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, First Affiliated Hospital of Air Force Medical University, Xi’an, ChinaDepartment of Radiation Oncology, First Affiliated Hospital of Air Force Medical University, Xi’an, ChinaDepartment of Radiation Oncology, The 940th Hospital of Joint Logistics Support force of Chinese People’s Liberation Army, Lanzhou, ChinaDepartment of Radiation Oncology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, ChinaObjectiveThe study aims to investigate if a relationship exists between vaginal doses and vaginal stenosis (VS) using posterior–inferior border of symphysis (PIBS) points and the International Commission on Radiation Units-Rectum (ICRU-R) point evaluation system for definitive radio(chemo)therapy in locally advanced cervical cancer.Methods and MaterialsFrom a vaginal dose study in China, 351 patients were prospectively assessed. For every reference point of the PIBS system and ICRU-R point was calculated for all BT and summed with EBRT. Pearson’s chi-square test and Student’s unpaired t-test compared variables with and without vaginal stenosis (VS) G ≥2. The risk factors were assessed for VS G ≥2 in multi- and univariate analyses through Cox proportional hazards model followed by a dose–effect curve construction. The VS morbidity rate was compared via the log-rank test using the median vaginal reference length (VRL).ResultsThe patients (38-month median follow-up) had 21.3% three-year actuarial estimate for VS G ≥2. Compared to G <2 patients, VS G ≥2 patients received higher doses to PIBS points except for PIBS − 2 and had significantly shorter VRL. VRL (HR = 1.765, P = 0.038), total EBRT and BT ICRU-R point dose (HR = 1.017, p = 0.003) were risk factors for VS. With VRL >4.6 cm, the 3-year actuarial estimate was 12.8% vs. 29.6% for VRL ≤4.6 cm. According to the model curve, the risks were 21, 30, and 39% at 75, 85, and 95 Gy, respectively (ICRU-R point dose).ConclusionsPIBS system point doses correlated with late vaginal toxicity. VRL combined with both EBRT and BT dose to the ICRU-R point contribute to VS risk.https://www.frontiersin.org/articles/10.3389/fonc.2022.840144/fullradiotherapyPIBS points systemICRU rectum pointvaginal stenosiscervical cancer |
| spellingShingle | Juan Wang Kai-shuo Zhang Zi Liu Tao Wang Rui-hua Wang Fu-quan Zhang Lang Yu Ya-li Wang Li-chun Wei Mei Shi Sha Li Bao-gang Liu Fan Shi Jin Su Wei Yuan Qi ying Zhang Jing Zhang Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical Cancer Frontiers in Oncology radiotherapy PIBS points system ICRU rectum point vaginal stenosis cervical cancer |
| title | Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical Cancer |
| title_full | Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical Cancer |
| title_fullStr | Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical Cancer |
| title_full_unstemmed | Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical Cancer |
| title_short | Using New Vaginal Doses Evaluation System to Assess the Dose–Effect Relationship for Vaginal Stenosis After Definitive Radio(Chemo)Therapy for Cervical Cancer |
| title_sort | using new vaginal doses evaluation system to assess the dose effect relationship for vaginal stenosis after definitive radio chemo therapy for cervical cancer |
| topic | radiotherapy PIBS points system ICRU rectum point vaginal stenosis cervical cancer |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.840144/full |
| work_keys_str_mv | AT juanwang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT kaishuozhang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT ziliu usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT taowang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT ruihuawang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT fuquanzhang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT langyu usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT yaliwang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT lichunwei usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT meishi usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT shali usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT baogangliu usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT fanshi usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT jinsu usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT weiyuan usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT qiyingzhang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer AT jingzhang usingnewvaginaldosesevaluationsystemtoassessthedoseeffectrelationshipforvaginalstenosisafterdefinitiveradiochemotherapyforcervicalcancer |