To evaluate the effects of radiation dose in prostate radiation therapy (RT) on occludin expression and ultrasonography characteristics of the bladder.
Urine samples of 64 prostate RT patients were collected before, at regular intervals during, and 3 months after RT. Occludin expression analysis was performed, and bladder wall echogenicity and echotexture were investigated by ultrasound and the gray-scale histogram analysis method. The bladder equivalent uniform dose (EUD) was derived from individually produced dose treatment plan for each patient. Clinical scoring for bladder-specific symptoms was done using the Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria Scale.
Thirty patients (47%) experienced at least 1 of the studied bladder symptoms (grade ≥1 endpoints), including urinary pain, frequency, urgency, straining, incontinence, hematuria, dysuria, and nocturia. For these patients there were significant changes in urine occludin levels after starting the treatment compared with the baseline urine samples (P=.023). The mean bladder EUD that caused a significant change in occludin level, which occurred after the 15th RT session, was 26.9 Gy (range, 13.2-36.5 Gy, P=.020). In all patients a significant reduction in bladder echogenicity (P=.0137) and a significant change in its echotexture (P=.047) was found after the 10th RT session, after which the EUD to the bladder reached 17.9 Gy (range, 8.8-24.3 Gy).
Significant changes in occludin expression level and bladder wall echogenicity and echotexture occurred during prostate RT. Our findings suggest that a significant reduction in bladder echogenicity and increase in occludin expression during treatment can be associated with acute urinary complications.
International journal of radiation oncology, biology, physics. 2017 Jun 20 [Epub ahead of print]
Milad Baradaran-Ghahfarokhi, Alireza Amouheidari, Daryoush Shahbazi-Gahrouei, Hamid Reza Baradaran-Ghahfarokhi, Kari Tanderup, Wolfgang Dörr, Parvaneh Shokrani
Department of Medical Physics and Medical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences., Department of Radiation Oncology, Milad Hospital, Isfahan., Department of Medical Physics and Medical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Department of Molecular Medicine, Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Departments of Radiation Oncology, Clinical Medicine, and Oncology, Aarhus University, Aarhus, Denmark., Department of Radiation Oncology, Vienna General Hospital, Vienna, Austria., Department of Medical Physics and Medical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: .