Effect of Pelvic External Beam Radiation Therapy on Lower Urinary Tract Function of Pediatric Patients

IF 2.3 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2025-08-26 DOI:10.1002/pbc.31996

Michael H. Edwards, Andrew Nicklawsky, Gemma Beltran, Elizabeth Stein, Jennifer Pyrzanowski, Kyle Rove, Karlie Boone, Sarah Milgrom, Nicholas G. Cost

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Abstract

Background

Pediatric patients with pelvic solid tumors often receive multimodal treatment, but the long-term effects of this treatment on lower urinary tract (LUT) function are not well-described. This prospective cohort study (NCT05818462) investigates the effect of external beam radiation therapy (EBRT) on LUT function by comparing patient-reported outcome measures, non-invasive urodynamic studies, and post-void residuals (PVRs) amongst childhood cancer survivors (CCS).

Methods

All subjects were CCS greater than 1 year off-therapy for a pediatric solid tumor. Subjects were divided into cohorts by whether they had received pelvic EBRT. Research subjects completed the Dysfunctional Voiding Scoring system (DVSS) survey, uroflow testing, and PVR bladder scan.

Results

Thirty-two patients enrolled; half received pelvic EBRT (mean 30.0 Gy). There was an equal number of patients exposed to alkylators (69%) in each cohort. Radiation cohort was further off therapy (5.3 vs. 4.0 years). The pelvic radiation cohort was more likely to have abnormal uroflow patterns (81% vs. 56%, p = 0.12). The flow pattern distribution differed between groups (p = 0.03); the pelvic radiation cohort was more likely to have a “plateau”-shaped curve (44% vs. 6%) and abnormal PVR (odds ratio [OR] 9.0, p = 0.002). Exploratory conditional likelihood ratio models yielded potential associations between pelvic EBRT and LUTD, as well as a potential dose–response. There was no difference in DVSS scores between cohorts.

Conclusion

EBRT appears to affect LUT function in CCS who received pelvic EBRT. DVSS does not appear useful as a screening tool in this population. Further study is needed to better appreciate the impact of EBRT on LUT function and develop more accurate screening tools.

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查看原文本刊更多论文

盆腔外束放射治疗对小儿下尿路功能的影响。

背景：患有盆腔实体瘤的儿科患者经常接受多模式治疗，但这种治疗对下尿路（LUT）功能的长期影响尚未得到很好的描述。这项前瞻性队列研究（NCT05818462）通过比较儿童癌症幸存者（CCS）中患者报告的结果测量、非侵入性尿动力学研究和空后残留（PVRs），研究了外束放射治疗（EBRT）对LUT功能的影响。方法：所有儿童实体瘤患者均为CCS患者，停药1年以上。受试者根据是否接受盆腔EBRT分成队列。研究对象完成了功能障碍排尿评分系统（DVSS）调查、尿流测试和PVR膀胱扫描。结果：纳入32例患者；一半接受盆腔EBRT（平均30.0 Gy）。每个队列中接触烷基化剂的患者数量相等（69%）。放疗组治疗间隔时间更长（5.3年vs. 4.0年）。盆腔放射组更有可能出现异常尿流模式（81%对56%，p = 0.12）。两组间流型分布差异有统计学意义（p = 0.03）；盆腔放疗组更有可能出现“平台”型曲线（44% vs. 6%）和PVR异常（优势比[OR] 9.0, p = 0.002）。探索性条件似然比模型得出盆腔EBRT和LUTD之间的潜在关联，以及潜在的剂量反应。各组间DVSS评分无差异。结论：在接受盆腔EBRT治疗的CCS患者中，EBRT似乎会影响LUT功能。在这一人群中，DVSS作为筛查工具似乎并不有用。为了更好地了解EBRT对LUT功能的影响，开发更准确的筛查工具，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.