量化妇科肿瘤治疗后膀胱并发症的影响:系统回顾和meta回归。

IF 3.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Journal of Gynecologic Oncology Pub Date : 2025-09-01 Epub Date: 2025-04-07 DOI:10.3802/jgo.2025.36.e76
Reut Rotem, Daniel Galvin, Corina Oprescu, Ayala Hirsch, Barry A O'Reilly, Orfhlaith E O'Sullivan
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引用次数: 0

摘要

妇科癌症治疗,包括放疗和化疗,会导致各种膀胱并发症。治疗部位与膀胱的解剖接近主要解释了放疗后的并发症,而化疗通过全身机制导致膀胱功能障碍。本研究系统回顾了这些恶性肿瘤患者膀胱并发症的性质、程度和患病率,强调了治疗方式对膀胱功能的影响。我们对Embase、Scopus、PubMed/MEDLINE、CINAHL和Cochrane图书馆等数据库进行了全面的检索,重点关注接受放射治疗、化疗或同时接受妇科癌症治疗的妇女。采用随机效应模型进行meta回归,量化治疗对膀胱功能的影响。从15081次引用中,12项研究共纳入了12469名参与者。我们的分析揭示了广泛的膀胱并发症,尿失禁(UI)和膀胱过度活动症状是常见的,同时还有放射性膀胱炎和解剖缺陷形成。这些并发症的发生率各不相同,反映了治疗方式、癌症类型和患者特征的复杂性。具体来说,尿失禁率从2.6%到84%不等,而瘘管形成和输尿管狭窄的发生率仍然相对较低,但具有临床意义。尿动力学结果显示,多达44%的评估患者膀胱容量减少,逼尿肌过度活动增加,突出了治疗对膀胱功能的影响。膀胱并发症在妇科癌症幸存者中普遍存在,与化疗和放疗相关的发生率显著。以肿瘤和泌尿系统健康为重点的综合护理对提高幸存者的生活质量至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Quantifying the impact of bladder complications following gynecological cancer treatment: systematic review and meta-regression.

Quantifying the impact of bladder complications following gynecological cancer treatment: systematic review and meta-regression.

Quantifying the impact of bladder complications following gynecological cancer treatment: systematic review and meta-regression.

Quantifying the impact of bladder complications following gynecological cancer treatment: systematic review and meta-regression.

Objective: Gynecological cancer treatments, including radiotherapy (RT) and chemotherapy, leads to various bladder complications. The anatomical proximity of the treatment site to the urinary bladder primarily explains the complications following RT, while chemotherapy contribute to bladder dysfunction through systemic mechanisms. This study systematically reviews the nature, extent, and prevalence of bladder complications among women treated for these malignancies, underscoring the influence of treatment modalities on bladder function.

Methods: A comprehensive search of databases including Embase, Scopus, PubMed/MEDLINE, CINAHL, and the Cochrane Library was conducted, focusing on women undergoing RT, chemotherapy, or both for gynecological cancers. Meta-regression was performed to quantify the effects of treatments on bladder function, using random-effect models.

Results: From 15,081 citations, 12 studies with a total of 12,469 participants were included. Our analysis revealed a broad spectrum of bladder complications, with urinary incontinence (UI) and overactive bladder symptoms being common, alongside with radiation cystitis and anatomical defects formation. The prevalence of these complications varied, reflecting the complexity of treatment modalities, cancer types, and patient characteristics. Specifically, UI rates ranged from 2.6% to 84%, while the incidence of fistula formation and ureteral stenosis remained relatively low but clinically significant. Urodynamic findings showed reduced bladder capacity and increased detrusor overactivity in up to 44% of evaluated patients, highlighting treatment's impact on bladder function.

Conclusion: Bladder complications are prevalent among gynecological cancer survivors, with notable occurrences associated with chemotherapy and RT treatments. Integrated care focusing on both oncological and urological health is essential for enhancing survivors' quality of life.

Trial registration: PROSPERO Identifier: CRD42023467123.

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来源期刊
Journal of Gynecologic Oncology
Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY
CiteScore
6.00
自引率
2.60%
发文量
84
审稿时长
>12 weeks
期刊介绍: The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.
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