Objective. To analyze the clinicopathological characteristics associated with radiation-induced cystitis (RIC) in patients with cervical cancer treated with chemoradiotherapy (CRT) alone or postoperational (post-op) CRT. Methods. 107 patients with cervical cancer were retrospectively recruited into the study. The surgical status, FIGO staging, total and fractionated doses of radiotherapy (RT), and multiparameters including the dose, volume irradiated to the total bladder, and bladder wall were evaluated for RIC. The criteria on RIC were referred to CTCAE v5.0. Results. Surgical operation and post-op CRT were delivered in 65 patients and CRT or RT alone in 42 patients. Among those with post-op CRT, 33/34 (97.06%), 22/43 (51.16%), and 10/30 (33.33%) patients were classified as FIGO stage I, II, and III/IV, respectively. The incidence of RIC was 30.84% for the whole group with 87.87% occurred in stage I and II patients. The incidence of CTCAE grade 2 and beyond was significantly higher in patients treated with post-op CRT than those with CRT alone (13.85% vs 2.38%,  = 0.043). Further analyses showed that the CTCAE level of RIC in the post-op CRT group was related to the relatively smaller average bladder volume ( = 0.029), whereas the difference in volume of bladder and bladder wall irradiated to 35.0 Gy or 40.0 Gy was not statistically significant between patients with or without RIC. Conclusion. The combination of surgery and post-op CRT may increase the incidence and severity of radiation-induced cystitis when compared to CRT alone, suggesting that bladder dysfunction associated with surgical procedure might increase the frequency and severity radiation related bladder toxicity. Further study is merited.

中文翻译：

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宫颈癌患者放射性膀胱炎的临床病理因素分析

客观的。分析仅接受放化疗（CRT）或术后（post-op）CRT 治疗的宫颈癌患者与放射性膀胱炎（RIC）相关的临床病理特征。方法。该研究回顾性招募了 107 名宫颈癌患者。评估手术状态、FIGO 分期、放射治疗 (RT) 的总剂量和分次剂量以及多参数（包括剂量、照射到总膀胱的体积和膀胱壁）的 RIC。RIC的标准参考CTCAE v5.0。结果。65 名患者接受了外科手术和术后 CRT，42 名患者接受了 CRT 或单纯放疗。在术后进行CRT的患者中，分别有33/34（97.06%）、22/43（51.16%）和10/30（33.33%）的患者被分类为FIGO I、I​​I和III/IV期。全组RIC发生率为30.84%，其中I、II期患者占87.87%。接受术后 CRT 治疗的患者的 2 级及以上 CTCAE 发生率显着高于仅接受 CRT 的患者（13.85% vs 2.38%，=  0.043）。进一步分析显示，术后CRT组RIC的CTCAE水平与相对较小的平均膀胱体积相关（ =0.029），而照射到35.0 Gy或40.0 Gy的膀胱和膀胱壁体积差异无统计学意义。有或没有 RIC 的患者之间具有显着性。结论。与单独使用 CRT 相比，手术和术后 CRT 相结合可能会增加放射性膀胱炎的发生率和严重程度，这表明与手术相关的膀胱功能障碍可能会增加与放射相关的膀胱毒性的频率和严重程度。值得进一步研究。