PD22-08 RISK OF RADIATION-INDUCED FISTULA IS LOW AND MAY BE INCREASED IN PATIENTS WITH PRIOR PELVIC RADIATION OR CONCURRENT CHEMOTHERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS

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You have accessJournal of UrologyCME1 May 2022PD22-08 RISK OF RADIATION-INDUCED FISTULA IS LOW AND MAY BE INCREASED IN PATIENTS WITH PRIOR PELVIC RADIATION OR CONCURRENT CHEMOTHERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS Michael Sadighian, Nizar Hakam, Gregory Amend, Nathan Shaw, Peggy Tahir, Isabel Elaine Allen, Behnam Nabavizadeh, Jordan Holler, William Shibley, Kevin Li, Behzad Abbasi, Alexander Bell, Osama Mohamad, and Benjamin Breyer Michael SadighianMichael Sadighian More articles by this author , Nizar HakamNizar Hakam More articles by this author , Gregory AmendGregory Amend More articles by this author , Nathan ShawNathan Shaw More articles by this author , Peggy TahirPeggy Tahir More articles by this author , Isabel Elaine AllenIsabel Elaine Allen More articles by this author , Behnam NabavizadehBehnam Nabavizadeh More articles by this author , Jordan HollerJordan Holler More articles by this author , William ShibleyWilliam Shibley More articles by this author , Kevin LiKevin Li More articles by this author , Behzad AbbasiBehzad Abbasi More articles by this author , Alexander BellAlexander Bell More articles by this author , Osama MohamadOsama Mohamad More articles by this author , and Benjamin BreyerBenjamin Breyer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002564.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The purpose of this systematic review and meta-analysis is to aggregate and summarize existing data on fistula prevalence among patients with a history of pelvic radiotherapy for pelvic malignancy. METHODS: We queried PubMed, Embase, and Web of Science on October 7, 2020 for peer-reviewed publications pertaining to radiation-induced fistulas in the pelvis. For meta-analysis, we used the random-effects model, and we used the I2 statistic to quantify heterogeneity and the Newcastle-Ottawa Scale to assess risk of bias. RESULTS: Our meta-analysis included 37 cohort studies with a total of 22,614 patients exposed to pelvic radiotherapy between 1970 and 2019. Median follow-up time was 34 months (IQR 26-55). Pooled prevalence of radiation-induced fistula across all 37 cohort studies was 1% (95% CI: 1-2%, I2=74%, p=0.00). Fistula prevalence was higher in studies that included patients who were reradiated (7%, p=0.037) and patients on concurrent chemotherapy (3%, p=0.006) compared to those receiving radiotherapy alone (1%). No randomized controlled trials met inclusion criteria due to ambiguous and inconsistent reporting language for fistula occurrence. CONCLUSIONS: There is significant heterogeneity among published cohort studies reporting fistula as an outcome of pelvic radiotherapy. Patients undergoing pelvic radiotherapy appear at low risk for developing fistulas. Risk of radiation-induced fistula may be increased in patients undergoing reradiation and those undergoing concurrent chemotherapy. There is need for cohort studies and randomized controlled trials that are specifically designed to illuminate the risk and predictors of fistula in this population. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e406 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Sadighian More articles by this author Nizar Hakam More articles by this author Gregory Amend More articles by this author Nathan Shaw More articles by this author Peggy Tahir More articles by this author Isabel Elaine Allen More articles by this author Behnam Nabavizadeh More articles by this author Jordan Holler More articles by this author William Shibley More articles by this author Kevin Li More articles by this author Behzad Abbasi More articles by this author Alexander Bell More articles by this author Osama Mohamad More articles by this author Benjamin Breyer More articles by this author Expand All Advertisement PDF downloadLoading ...

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