skip to main content

Title: Pain and Mean Absorbed Dose to the Pubic Bone After Radiotherapy Among Gynecological Cancer Survivors

Purpose: To analyze the relationship between mean absorbed dose to the pubic bone after pelvic radiotherapy for gynecological cancer and occurrence of pubic bone pain among long-term survivors. Methods and Materials: In an unselected, population-based study, we identified 823 long-term gynecological cancer survivors treated with pelvic radiotherapy during 1991-2003. For comparison, we used a non-radiation-treated control population of 478 matched women from the Swedish Population Register. Pain, intensity of pain, and functional impairment due to pain in the pubic bone were assessed with a study-specific postal questionnaire. Results: We analyzed data from 650 survivors (participation rate 79%) with median follow-up of 6.3 years (range, 2.3-15.0 years) along with 344 control women (participation rate, 72 %). Ten percent of the survivors were treated with radiotherapy; ninety percent with surgery plus radiotherapy. Brachytherapy was added in 81%. Complete treatment records were recovered for 538/650 survivors, with dose distribution data including dose-volume histograms over the pubic bone. Pubic bone pain was reported by 73 survivors (11%); 59/517 (11%) had been exposed to mean absorbed external beam doses <52.5 Gy to the pubic bone and 5/12 (42%) to mean absorbed external beam doses {>=}52.5 Gy. Thirty-three survivors reported pain affecting sleep, a 13-fold increasedmore » prevalence compared with control women. Forty-nine survivors reported functional impairment measured as pain walking indoors, a 10-fold increased prevalence. Conclusions: Mean absorbed external beam dose above 52.5 Gy to the pubic bone increases the occurrence of pain in the pubic bone and may affect daily life of long-term survivors treated with radiotherapy for gynecological cancer.« less
Authors:
 [1] ;  [2] ;  [1] ;  [2] ;  [1] ; ;  [3] ;  [3] ;  [2] ;  [4] ;  [5] ;  [4] ;  [1] ;  [2]
  1. Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg (Sweden)
  2. (Sweden)
  3. Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm (Sweden)
  4. Departments of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg (Sweden)
  5. Department of Gynecologic Oncology, Karolinska University Hospital, Stockholm (Sweden)
Publication Date:
OSTI Identifier:
21587593
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 80; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2010.04.007; PII: S0360-3016(10)00511-0; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; NEOPLASMS; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; SKELETON; SURGERY; WOMEN ANIMALS; BODY; DISEASES; DOSES; FEMALES; MAMMALS; MAN; MEDICINE; NUCLEAR MEDICINE; ORGANS; PRIMATES; RADIOLOGY; RADIOTHERAPY; THERAPY; VERTEBRATES