[Late bladder complications following radiotherapy of carcinoma of the uterine cervix].
OBJECTIVE
To analyse the causes, clinical features, treatment and prevention of late bladder complications following radiotherapy of carcinoma of the uterine cervix.


METHODS
This clinical retrospective study included 378 cases of irradiation cystitis following radiotherapy for carcinoma of the uterine cervix from February, 1958 to October, 1987.


RESULTS
The incidence of irradiation cystitis was 3.2% and was not related to age, FIGO staging and the methods of intracavitary irradiation (conventional or afterloading). It was related to the external appearance of the local lesion; 66.5% of the tumors of patients with late bladder complications was of the exophytic type prior to radiotherapy. 51.1% of the patients developed late bladder complications in a period of 2-5 years after radiotherapy; 16.7% in 5-10 years and only 3.4% within the first years. The patients with irradiation cystitis had received a 10% higher dosage than that routine delivered, as found either in intracavitary irradiation of 39.4% of patients or in external irradiation of 31.6% of patients. Based on the clinical features and cystoscopic findings, late bladder complications can be divided into three types: (1) sudden and temporary hematuria (35.7%); (2) persistent hematuria (63.2%); and (3) vesico-vaginal fistula (1.1%). The 5-year survival rate of patients with irradiation cystitis was 90.4% which was higher than the survival rates of all patients treated by conventional intracavitary irradiation (65.7%) and all patients treated by afterloading intracavitary irradiation (70.4%). 3.7% of patients died of late bladder complications.


CONCLUSIONS
To decrease the occurrence of late bladder complications and to obtain long term survival: (1) Dosage to the bladder should be adequate, and over dose to the bladder should by all means be avoided; (2) Patients are to be taught to observe indicated personal care during radiotherapy as well as in the follow-up period; (3) Early institution of proper conservative treatment of cystitis is beneficial.
Li
A
A
Cancer Hospital of Chinese Academy of Medical Sciences, Beijing.
Sun
J
J
Chao
H
H
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D003556:Cystitis / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*