ACUTE TOXICITY PROFILE OF CERVICAL AND UTERINE CANCER PATIENTS TREATED WITH CHEMORADIATION: A 10-YEAR REVIEW
2 Department of Radiation and Clinical Oncology, National Hospital, Abuja
3 Department of Radiation and Clinical Oncology, Ahmadu Bello University Teaching Hospital, Zaria
4 Department of Radiation and Clinical Oncology, University College Hospital, Ibadan
5 Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Zaria
6 Department of Histo-Pathology, Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria
7 Department of Surgery, Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria.
* Corresponding author: ytukur06@gmail.com
Abstract
Background: Radiation therapy is integral to treating many gynaecologic cancers.
Objective: We sought to determine the frequency and severity of acute toxicity in patients who had pelvic radiotherapy for cervical and uterine cancers.
Methods: A retrospective study of all women who had pelvic radiation for cervical and uterine cancers at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, from January 2010 to December 2019.
All cases of cervical and uterine cancers that met the inclusion criteria were studied. A structured pro forma was used to extract relevant data from patients’ case files and treatment cards. Information obtained included biodata, site and size of tumour, dose of radiation prescribed to the pelvis, date of completion of external beam radiotherapy (EBRT) as well as dose of radiation received from EBRT, cycles of chemotherapy, the cytotoxics used and dose, interval between both therapies, side effects during and after EBRT (follow-up), disease status on follow-up period. Toxicity profile was recorded based on Radiation Therapy Oncology Group (RTOG)/European Organisation for Research and Treatment of Cancer (EORTC) Late Radiation Morbidity Scoring Scheme.
Result: Most patients seen in the study were of the age group 41-50 years, with cervical cancer being by far the commoner of the two (2) gynaecological cancers treated with chemoradiation in this study. Majority of the cases were diagnosed at stage IIIA. The most prescribed radiation dose from EBRT was 50Gy in 25 fractions. The study showed that acute toxicity had a similar pattern as compared to studies conducted in other regions of the world. The acute toxicity profile of pelvic radiotherapy in women with cervical and endometrial cancer was found to be mainly mild to moderate. Gastrointestinal toxicity was the most frequently observed toxicity, followed by urinary and hematologic toxicity. In this study, most common acute reactions (64.9%) occurred in the gastrointestinal system, with 60.6% having grade 1 and 4.3% grade 2 toxicity for cervical cancer patients, while those with endometrial cancer recorded 50% grade 1 and 3% grade 2 toxicity.
Conclusion: The frequency and severity of acute toxicity of pelvic radiotherapy in women with gynaecologic cancers were found to be mild to moderate.
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