Yıl: 2019 Cilt: 16 Sayı: 4 Sayfa Aralığı: 260 - 265 Metin Dili: İngilizce DOI: 10.4274/tjod.galenos.2019.56957 İndeks Tarihi: 30-10-2020

Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy

Öz:
Objective: Although diabetes is a common co-morbidity in patients with gynecologic cancer, information about its impact on radiation toxicity in patients withgynecologic cancer treated with external pelvic irradiation is scarce. We aimed to investigate the relation of diabetes with acute toxicity in patients with gynecologictumors who underwent pelvic +/- paraaortic radiotherapy.Materials and Methods: One hundred twenty-nine patients with endometrium or cervix carcinoma were enrolled in the study. Demographic features, presenceof diabetes, incidence and severity of upper gastrointestinal (UGIS), lower gastrointestinal (LGIS), and urinary symptoms were recorded from files. Correlationand logistic regression analysis was used to determine the impact of diabetes, age, chemotherapy, paraaortic irradiation on toxicities, and a prediction model wasdeveloped.Results: The median age of 77 patients with endometrium cancer and 52 cervix cancer was 61 (range, 25-92) years, and 28 (21.7%) of them had diabetes. Themedian pelvic and tumor/tumor bed dose was 5040+247.65 cGy and 5040+222.91 cGy, respectively. Age and Gr 0 UGIS toxicity were significantly related(p=0.047). LGIS Gr 0 toxicity was found to be significantly higher in patients with diabetes (p=0.045). Gr 0 and 2 UGIS toxicities were both found to be significantlycorrelated with paraaortic irradiation (both p<0.001). Diabetes is also an important determinant on UGIS toxicity in patients who underwent paraaortic irradiation.Conclusion: The correlation we found between toxicity and diabetes, concurrent chemotherapy or paraaortic radiation necessitates special care and risk stratificationfor patients with diabetes. Further prospective studies with long follow-up and larger patient groups are warranted.
Anahtar Kelime:

Jinekolojik tümörlerde radyoterapi sonrası gastrointestinal ve üriner toksisite üzerinde diyabetin etkisi

Öz:
Amaç: Jinekolojik tümörlerde diyabet oldukça sık rastlanan bir komorbidite olmasına rağmen eksternal pelvik radyoterapi alan bu hastalarda diyabetin radyasyon toksisitesi üzerine etkisi ile ilgili bilgiler oldukça sınırlıdır. Bu çalışmada pelvik +/- paraaortik radyoterapi alan jinekolojik malignite hastalarında diyabetin akut radyasyon toksisitesi üzerine etkisinin araştırılması amaçlandı. Gereç ve Yöntemler: Yüz yirmi dokuz endometrium veya serviks kanserli hasta çalışmaya dahil edildi. Demografik özellikler, diyabet bilgisi, üst gastrointestinal (UGIS), alt gastrointestinal (LGIS) ve üriner semptomlar, tedavi bilgileri dosyalardan elde edildi. Diyabetin ve tedavi modalitelerinin toksisite üzerine etkisi korelasyon ve lojistik regresyon analizi ile değerlendirildi. Ek olarak toksisite prediksiyon modeli geliştirildi. Bulgular: Yetmiş yedi endometrium ve 52 serviks kanserli olgunun medyan yaşı 61 (25-92) yıl olarak bulundu ve 28 (%21,7) hastada diyabet mevcut idi. Medyan pelvik ve tümör/tümör yatağı dozu sırasıyla 5040+247,65 cGy ve 5040+222,91 cGy idi. Yaş ve Gr 0 UGIS toksisitesi anlamlı düzeyde ilişkili olarak bulundu (p=0,047). Gr 0 LGIS toksisitesi diyabetik hastalarda anlamlı düzeyde yüksek idi (p=0,045). Gr 0 ve 2 UGIS toksisitesi ile pararaortik radyoterapi arasında istatistiksel anlamlı korelasyon saptandı (both p<0,001). Paraaortik radyoterapi uygulanan hastalarda UGIS toksisitesi açısından diyabet varlığının belirleyici rol oynadığı saptandı. Sonuç: Toksisite ile diyabet, eş zamanlı kemoterapi, paraaortik radyoterapi arasında bulduğumuz ilişki diyabetik hastaların radyoterapi öncesinde özenle değerlendirilmesi ve risklerinin belirlenmesi gerektiğini göstermektedir. Daha uzun takipli ve daha fazla hasta sayısı ile yapılacak yeni çalışmalara ihtiyaç vardır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Ozkan E, Erdemoglu E, Raoufi J (2019). Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. , 260 - 265. 10.4274/tjod.galenos.2019.56957
Chicago Ozkan E. Elif,Erdemoglu Evrim,Raoufi Jalal Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. (2019): 260 - 265. 10.4274/tjod.galenos.2019.56957
MLA Ozkan E. Elif,Erdemoglu Evrim,Raoufi Jalal Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. , 2019, ss.260 - 265. 10.4274/tjod.galenos.2019.56957
AMA Ozkan E,Erdemoglu E,Raoufi J Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. . 2019; 260 - 265. 10.4274/tjod.galenos.2019.56957
Vancouver Ozkan E,Erdemoglu E,Raoufi J Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. . 2019; 260 - 265. 10.4274/tjod.galenos.2019.56957
IEEE Ozkan E,Erdemoglu E,Raoufi J "Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy." , ss.260 - 265, 2019. 10.4274/tjod.galenos.2019.56957
ISNAD Ozkan, E. Elif vd. "Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy". (2019), 260-265. https://doi.org/10.4274/tjod.galenos.2019.56957
APA Ozkan E, Erdemoglu E, Raoufi J (2019). Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. Turkish Journal of Obstetrics and Gynecology, 16(4), 260 - 265. 10.4274/tjod.galenos.2019.56957
Chicago Ozkan E. Elif,Erdemoglu Evrim,Raoufi Jalal Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. Turkish Journal of Obstetrics and Gynecology 16, no.4 (2019): 260 - 265. 10.4274/tjod.galenos.2019.56957
MLA Ozkan E. Elif,Erdemoglu Evrim,Raoufi Jalal Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. Turkish Journal of Obstetrics and Gynecology, vol.16, no.4, 2019, ss.260 - 265. 10.4274/tjod.galenos.2019.56957
AMA Ozkan E,Erdemoglu E,Raoufi J Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. Turkish Journal of Obstetrics and Gynecology. 2019; 16(4): 260 - 265. 10.4274/tjod.galenos.2019.56957
Vancouver Ozkan E,Erdemoglu E,Raoufi J Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. Turkish Journal of Obstetrics and Gynecology. 2019; 16(4): 260 - 265. 10.4274/tjod.galenos.2019.56957
IEEE Ozkan E,Erdemoglu E,Raoufi J "Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy." Turkish Journal of Obstetrics and Gynecology, 16, ss.260 - 265, 2019. 10.4274/tjod.galenos.2019.56957
ISNAD Ozkan, E. Elif vd. "Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy". Turkish Journal of Obstetrics and Gynecology 16/4 (2019), 260-265. https://doi.org/10.4274/tjod.galenos.2019.56957