{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:39:50Z","timestamp":1787071190159,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective:<\/jats:title>\n Image-Guided Adaptive Brachytherapy (IGABT) provides a survival advantage in locally advanced cervical cancer (LACC). Although side effects are seen less with this technique, dose parameters that cause urinary side effects are still questionable. We aim to investigate whether the radiotherapy doses of the lower urinary tract substructures (LUSS) affect the urinary system side effects (USSE) of cervical cancer external beam radiotherapy (EBRT) and the IGABT.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n LUSS (bladder, trigone, bladder neck, and urethra) doses were calculated in 40 patients diagnosed with LACC and receiving primary EBRT, IGABT, and concomitant chemotherapy. D\n 0.1cc<\/jats:sub>\n , D\n 2cc<\/jats:sub>\n , and D\n 50%<\/jats:sub>\n values were examined by contouring the bladder, trigone, bladder neck, and urethra from the intracavitary BT planning computed tomography (CT) images taken every 4 BT fractions, retrospectively. Besides, late USSE (urgency, dysuria (recurrent), frequency, obstruction, incontinence, hematuria, fistula, cystitis) were queried and categorized according to Common Toxicity Criteria for Adverse Events version 5.0.\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Analysis Used:<\/jats:title>\n \n The Chi-square and Fisher\u2019s exact tests, Mann\u2013Whitney\n U<\/jats:italic>\n -test.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n For the whole study population, for both incontinence and dysuria, trigone (D\n 50%<\/jats:sub>\n ), urethra (D\n 50%<\/jats:sub>\n , D\n 0.1cc,<\/jats:sub>\n ), and bladder neck (D\n 50%<\/jats:sub>\n , D\n 0.1cc,<\/jats:sub>\n D\n 2cc<\/jats:sub>\n ) volume and hot spot doses remained significant. For cystitis, urethra (D\n 50%<\/jats:sub>\n , D\n 0.1cc,<\/jats:sub>\n ) and bladder neck doses (D\n 0.1cc<\/jats:sub>\n , D\n 50%<\/jats:sub>\n , D\n 2cc<\/jats:sub>\n ) are worth investigating.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Although USSE is less common in the intensity-modulated radiation therapy and IGABT era, it may be meaningful to take the doses of LUSS into account when planning IGABT. In addition, delineation of LUSS using only CT seems feasible. More proof is needed to determine delineation technique and dose constraints for LUSS for IGABT.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcrt.jcrt_2353_21","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T12:02:01Z","timestamp":1703937721000},"page":"1825-1830","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["The effect of lower urinary tract substructure doses on side effects of cervical cancer image-guided adaptive brachytherapy"],"prefix":"10.4103","volume":"19","author":[{"given":"Can","family":"Azak","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gizem","family":"Kavak","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferihan","family":"Ertan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Alio\u011flu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebru Atasever","family":"Akka\u015f","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"G\u00f6ksel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebru","family":"Karakaya","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"R1-20241021","first-page":"33","article-title":"American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix","volume":"11","author":"Viswanathan","year":"2012","journal-title":"Part I:General principles. 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