Clinical analysis of predisposing factors for radiation enteritis in patients with cervical cancer

Abstract

Objective: Radiation enteritis (RE) is one of the most common radiation-induced toxicities in patients with cervical cancer undergoing pelvic radiotherapy. This study aimed to evaluate predisposing factors for RE in patients with cervical cancer. Methods: In total, 414 patients with cervical cancer undergoing radiotherapy were retrospectively enrolled from Anhui Provincial Cancer Hospital. We collected data on age; body mass index; International Federation of Gynecology and Obstetrics stage (I–IV); histology; fasting blood glucose levels; chemotherapy regimen; radiation dose; and histories of hypertension, diabetes mellitus, and surgery. Univariate and multivariate Cox regression analyses were used to assess possible predisposing factors for RE. Results: Incidences of acute RE (ARE) and chronic RE (CRE) were 65.2% and 13.1%, respectively. No prior surgery, radiation dose ≥56 Gy, hypertension, and hyperglycemia were found to be independent risk factors for ARE (95% confidence interval [CI], p < 0.05). Hypertension, diabetes mellitus, and hyperglycemia were independent risk factors for CRE (95% CI, p ≤ 0.01). Significantly higher incidences of ARE (90.6% vs. 75.8%, p < 0.001) and CRE (62.5% vs. 21.2%, p = 0.001) were found in patients with diabetes mellitus and poor glucose control. Conclusions: To reduce the occurrence of RE in patients with cervical cancer, comorbidities such as diabetes mellitus, hyperglycemia, and hypertension should be controlled, along with consideration of treatment-related factors such as the radiotherapy method and total radiation dose.