Clinical-laboratory portrait of patients with cervical cancer with late radiation toxicity due to radiation therapy.

Abstract

According to the National Cancer Registry of Ukraine, cervical cancer ranks second among cancer morbidity, in women of reproductive age and the first place (14.1% of all cases) in the mortality from malignant neoplasms in women aged 18-29, and in aggregate almost 1.7 thousand women die from this pathology in Ukraine annually. Radiation therapy plays a leading role in the treatment of this pathology. In turn, an increase in the survival rate after the course of combined treatment leads to an increase in the absolute number of patients with adverse effects of treatment, in particular, late radiation toxicity (LRT). A retrospective analysis of 254 case histories of patients with malignant cervical neoplasms (127 patients with late radiation toxicity and 127 patients without late radiation toxicity) was conducted. Depending on the nature of the genesis of the late radiation toxicity, it has been found that inflammatory changes occurr in 95.3% of patients (atrophic cystitis, radiation recticite, radial enterocolitis, radiation retropsychoiditis, etc.); in 32,3% – late radiation toxicity of fibrotic genesis (intrapulmonary radiation, ureter stenosis, fibrosis of the skin and subcutaneous tissue of the irradiation fields, etc.); in 25.2% – degenerative late radiation toxicity (radial ulcers, fistulas, etc.) and 30.7% – hematologic late radiation toxicity. The comparative analysis of clinical and laboratory parameters of patients before and after radiotherapy with regard to cervical cancer has shown that prognostic factors of late radiation toxicity such as increase in hematocrit and fibrinogen indices deserve attention. It has also been established that the presence of laboratory signs of a cytolytic syndrome (increased levels of aspartate aminotransferase, urea and total protein) in patients with cervical cancer prior to radiation therapy can be a prerequisite for the formation of late radiation toxicity. In addition, it has been shown that the presence of concomitant aggravating diseases of the endocrine system, blood system, musculoskeletal system, nervous system and digestive system is statistically significantly (p<0,05) increases the risk of LRT in patients with cervical cancer by 20,2; 7.0; 2.3; 1.8 and 1.6 times respectively.