Impact of pre-brachytherapy indwelling urinary catheters on comfort and psychological well-being patients with cervical cancer

Abstract

This study aimed to explore the effects of indwelling urinary catheters before brachytherapy on patient comfort and psychological stress in cervical cancer patients. A total of 140 patients with stage IIA or higher cervical cancer were randomly assigned to two groups: The indwelling catheter group (n = 70) and the non-indwelling catheter group (n = 70). Radiation exposure risks were compared using dose-volume histograms. Brachytherapy, a high-dose-rate micro-radiation therapy, was performed using the Utrecht applicator. Tumor treatment efficacy and levels of norepinephrine (NE), cortisol (Cor), and adrenocorticotropic hormone (ACTH) were measured. The patient’s fear, psychological state, comfort, and quality of life were evaluated before and after the intervention. Results showed that radiation exposure to healthy tissues was lower in the indwelling catheter group (P < 0.05), with a reduced rate of excessive radiation exposure compared to the non-indwelling catheter group. Before the intervention, the indwelling catheter group had higher Fear of Progression Questionnaire-Short Form (FoP-Q-SF) scores, but no significant difference was observed between groups after the intervention. Tumor size was smaller in the indwelling catheter group, and treatment outcomes were significantly better. Levels of NE, Cor, and ACTH were higher in the indwelling catheter group. Comfort scores were lower in the indwelling catheter group, but their quality of life was better compared to the non-indwelling catheter group. In conclusion, the use of indwelling catheters in brachytherapy for cervical cancer improves treatment outcomes and quality of life. While it may cause temporary discomfort and psychological stress, no long-term negative effects were observed.

Keywords

Cervical cancer / Brachytherapy / Indwelling catheter / Comfort / Psychological stress

References

[1] Kajimoto Y, Honda K, Suzuki S, et al. Association between financial toxicity and health-related quality of life of patients with gynecologic cancer. Int J Clin Oncol. 2023; 28(3):454-467. doi: 10.1007/s10147-023-02294-1

[2] Gennigens C, De Cuypere M, Hermesse J, Kridelka F, Jerusalem G. Optimal treatment in locally advanced cervical cancer. Expert Rev Anticancer Ther. 2021; 21:657-671. doi: 10.1080/14737140.2021.1879646

[3] Hori S, Tomizawa M, Inoue K, et al. Clinical impact of catheter insertion for peritoneal dialysis on patient survival and catheter-related complications. Clin Exp Nephrol. 2023; 27(11):941-950. doi: 10.1007/s10157-023-02382-6

[4] Mayadev JS, Ke G, Mahantshetty U, Pereira MD, Tarnawski R, Toita T. Global challenges of radiotherapy for the treatment of locally advanced cervical cancer. Int J Gynecol Cancer. 2022; 32:436-445. doi: 10.1136/ijgc-2021-003001

[5] Warner ET, Park ER, Luberto CM, Rabin J, Perez GK, Ostroff JS. Internalized stigma among cancer patients enrolled in a smoking cessation trial: The role of cancer type and associations with psychological distress. Psychooncology. 2021; 31(5):753-760. doi: 10.1002/pon.5859

[6] Tseng P, Zeng B, Wang H, et al. Efficacy and acceptability of noninvasive brain stimulation for treating posttraumatic stress disorder symptoms: A network meta‐analysis of randomized controlled trials. Acta Psychiatr Scand. 2024; 150(1):5-21. doi: 10.1111/acps.13688

[7] Toita T, Wada K, Sutani S, et al. Definitive radiotherapy consisting of external beam radiotherapy without central shielding and 3D image-guided brachytherapy for patients with cervical cancer: Feasibility for Japanese patients and dose-response analyses for local control in the low-dose range. Jpn J Clin Oncol. 2023; 53(6):480-488. doi: 10.1093/jjco/hyad022.

[8] Musunuru HB, Pifer PM, Mohindra P, Albuquerque K, Beriwal S. Advances in management of locally advanced cervical cancer. Indian J Med Res. 2021; 154(2):248-261. doi: 10.4103/ijmr.IJMR_1047_20

[9] Blackburn L, Hill C, Lindsey A, Sinnott L, Thompson K, Quick A. Effect of foot reflexology and aromatherapy on anxiety and pain during brachytherapy for cervical cancer. Oncol Nurs Forum. 2021; 48(3):265-276. doi: 10.1188/21.onf.265-276

[10] Wang J, Lv N, Yang L, Zhu Y, Sun L. Family resilience and its influencing factors in patients with stress urinary incontinence after cervical cancer surgery: A retrospective study. Arch Esp Urol. 2024; 77(4):397. doi: 10.56434/j.arch.esp.urol.20247704.54.

[11] Ng AP, Sanaiha Y, Verma A, et al. Insurance-based disparities and risk of financial toxicity among patients undergoing gynecologic cancer operations. Gynecol Oncol. 2022; 166(2):200-206. doi: 10.1016/j.ygyno.2022.05.017

[12] Dirar A, Mekonnen W, Berhanu Z. The experiences of cervical cancer patients during follow-up care in Ethiopia: A qualitative study. Cancer Manag Res. 2022; 14:2507-2518. doi: 10.2147/cmar.s373379

[13] Schmid MP, Lindegaard JC, Mahantshetty U, et al. Risk factors for local failure following chemoradiation and magnetic resonance Image-Guided brachytherapy in locally advanced cervical cancer: Results from the EMBRACE-I study. J Clin Oncol. 2023; 41(10):1933-1942. doi: 10.1200/jco.22.01096

[14] González-Sanchis A, Brualla-González L, Fuster-Diana C, et al. Surface-guided radiation therapy for breast cancer: More precise positioning. Clin Transl Oncol. 2021; 23(10):2120-2126. doi: 10.1007/s12094-021-02617-6

[15] Chargari C, Peignaux K, Escande A, et al. Radiotherapy of cervical cancer. Cancer Radiothér. 2021; 26(1-2):298-308. doi: 10.1016/j.canrad.2021.11.009

[16] Assmann W, Becker R, Stief C, Sroka R. Development and pre-clinical test of a phosphorous-32 containing polyetheretherketone foil aiming at urethral stricture prevention by low-dose-rate brachytherapy. J Contemp Brachyther. 2022; 14(2):189-197. doi: 10.5114/jcb.2022.115205

[17] Mahantshetty U, Poetter R, Beriwal S, et al. IBS-GEC ESTRO-ABS recommendations for CT based contouring in image guided adaptive brachytherapy for cervical cancer. Radiother Oncol. 2021; 160:273-284. doi: 10.1016/j.radonc.2021.05.010

[18] Aviki EM, Manning-Geist BL, Sokolowski SS, et al. Risk factors for financial toxicity in patients with gynecologic cancer. Am J Obstet Gynecol. 2021; 226(6):817.e1-817.e9. doi: 10.1016/j.ajog.2021.12.012

[19] Lichter K, Anakwenze Akinfenwa C, MacDuffie E, et al. Treatment of cervical cancer: Overcoming challenges in access to brachytherapy. Exp Rev Anticancer Ther. 2022; 22(4):353-359. doi: 10.1080/14737140.2022.2047936

[20] Tian X, Li C, Hou Y, et al. Artificial intelligence in brachytherapy for cervical cancer. J Cancer Res Ther. 2022; 18(5):1241-1246. doi: 10.4103/jcrt.jcrt_2322_21

[21] Pötter R, Tanderup K, Schmid MP, et al. MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): A multicentre prospective cohort study. Lancet Oncol. 2021; 22(4):538-547. doi: 10.1016/S1470-2045(20)30753-1

[22] Shen Z, Qu A, Jiang P, Jiang Y, Sun H, Wang J. Re-irradiation for recurrent cervical cancer: A state-of-the-art review. Curr Oncol. 2022; 29(8):5262-5277. doi: 10.3390/curroncol29080418

[23] Abdul-Latif M, Tharmalingam H, Tsang Y, Hoskin PJ. Functional magnetic resonance imaging in cervical cancer diagnosis and treatment. Clin Oncol (R Coll Radiol). 2023; 35(9):598-610. doi: 10.1016/j.clon.2023.05.006

[24] Tseng M, Ngoi NY, Tan DS, Tong PS. Combined modality management of advanced cervical cancer including novel sensitizers. Int J Gynecol Cancer. 2022; 32(3):246-259. doi: 10.1136/ijgc-2021-003137

[25] Billone V, Gullo G, Perino G, et al. Robotic versus mini-laparoscopic colposacropexy to treat pelvic organ prolapse: A retrospective observational cohort study and a medicolegal perspective. J Clin Med. 2024; 13(16):4802. doi: 10.3390/jcm13164802

[26] Gullo G, Etrusco A, Cucinella G, et al. Ovarian tissue cryopreservation and transplantation in menopause: New perspective of therapy in postmenopausal women and the importance of ethical and legal frameworks. Eur Rev Med Pharmacol Sci. 2022; 26(24):9107-9116. doi: 10.26355/eurrev_202212_30660