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Abstract
Introduction/Background Radiation cystitis (RC) is a common side-effect of radiation to the pelvis. Symptoms include increased frequency, urgency, dysuria, gross hematuria, and even necrotic bladder tissue, which could severely impair patients‘ quality of life. Platelet-to-albumin ratio (PAR) is a new systemic inflammatory prognostic indicator associated with many inflammatory diseases. However, its role in RC is underinvestigated. This study explored whether PAR could be an effective biomarker for predicting the RC for local advanced cervical cancer treated with radiotherapy.
Methodology 319 local advanced cervical cancer patients at our institute were enrolled in this study between December 2018 and January 2021. All patients received radiotherapy with or without chemotherapy. Demographics and clinical parameters were retrospectively analyzed. Univariate and multivariate analyses were used to identify the risk factors for RC. A backward and stepwise regression was used to establish two nomograms—one with primary significant factors and the other with extra inflammatory biomarkers. The nomogram’s prediction power was assessed.
Results Univariate analysis showed that age, tumor size, stage, total radiation dose, pelvic radiation dose, PLR, SII, PLR, and PAR were significantly associated with RC occurrence (all p < 0.05). Multivariate analyses indicated that age, tumor size, stage, total radiation dose, and PAR were independent factors (all p < 0.05). Then, the AUC value of the nomogram based on SII+PAR was 0.774 compared to that of the baseline nomogram(AUC=0.726) ( P Delong=0.02), indicating the critical roles of SII and PAR in predicting RC. Moreover, the calibration curve and DCA exhibited good prediction consistency and clinical practicability of the nomogram based on SII+PAR.
Conclusion PAR and SII values, especially PAR, should be calculated at admission for CC patients with radiation therapy to identify patients who require more decisive extra intervention to limit bladder radiation damage and improve patients‘ quality of life.
Disclosures This work was supported by the Major Scientific Research Program for Young and Middle-aged Health Professionals of Fujian Province, China(Grant No. 2022ZQNZD008).
