AKUTNA RADIJACIONA TOKSIČNOST ZA VREME I POSLE HEMORADIOTERAPIJE KOD PACIJENTKINJA SA LOKALNO UZNAPREDOVALIM KARCINOMOM CERVIKSA UTERUSA

  • Marija N Živković Radojević Univezitet u Kragujevcu, Srbija, Fakultet medicinsih nauka Klinički Centar Kragujevac, Centar za onkologiju i radiologiju, Odeljenje radioterapije
  • Vesna Plesinac Karapandzić Univerzitet u Beogradu, Srbija, Medicinski fakultet Institut za onkologiju i radiologiju Srbije
  • Aleksandar Tomašević Institut za onkologiju i radiologiju Srbije
  • Neda Milosavljević Klninički centar u Kragujevcu, Centar za onkologiju i radiologiju, Odeljenje radioterapije
  • Marko Folić Univerzitet u Kragujevcu, Srbija, Fakultet medicinskih nauka Klinički centar Kragujevac, Služba za kliničku farmakologiju
Ključne reči: risk factors||, ||faktori rizika, acute radiation toxicity||, ||akutna radijaciona toksičnost, locally advanced cervical cancer||, ||lokalno uznapredovali cerviks uterusa,

Sažetak


Karcinom cerviksa uterusa se nalazi na alarmantnom 4. mestu među malignim tumorima kod žena, i predstavlja globalni problem. Zlatni standard u lečenju lokalno uznapredovalog karcinoma cerviksa uterusa je hemoradioterapija (eksterno zračenje i brahiterapija). Međutim, za vreme lečenja karcinoma cerviksa uterusa nastaju različiti oblici akutne toksičnosti, koji uključuju oštećenja krvnih loza, gastrointestinalne, genitourinarne i dermatološke probleme.

Mada je većina potencijalnih faktora rizika za pojavu akutne radijacione toksičnosti vezana za pojedine modalitete terapije, treba uvek uzeti u obzir individualne karakteristike pacijenata. Poznavanje potencijalnih faktora rizika i rano otkrivanje  pacijenata sa povećanim rizikom od akutne radijacione toksičnosti može značajno doprineti primeni adekvatnih korektivnih mera koje će sprečiti i akutnu i još kompleksniju hroničnu radijacionu toksičnost. Takav pristup dovodi i do poboljšanja kvaliteta života pacijenata sa lokalno uznapredovalim karcinomom cerviksa uterusa. 

 

 

 

Biografije autora

Marija N Živković Radojević, Univezitet u Kragujevcu, Srbija, Fakultet medicinsih nauka Klinički Centar Kragujevac, Centar za onkologiju i radiologiju, Odeljenje radioterapije

Doktor medicine

Vesna Plesinac Karapandzić, Univerzitet u Beogradu, Srbija, Medicinski fakultet Institut za onkologiju i radiologiju Srbije
Prof. dr
Aleksandar Tomašević, Institut za onkologiju i radiologiju Srbije
dr
Neda Milosavljević, Klninički centar u Kragujevcu, Centar za onkologiju i radiologiju, Odeljenje radioterapije
dr sci med
Marko Folić, Univerzitet u Kragujevcu, Srbija, Fakultet medicinskih nauka Klinički centar Kragujevac, Služba za kliničku farmakologiju
Prof. dr

Reference

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018. PP

Wang JQ, Wang T, Shi F, Yang YY, Su J, Chai YL, Liu Z. A Randomized Controlled Trial Comparing Clinical Outcomes and Toxicity of Lobaplatin- Versus Cisplatin-Based Concurrent Chemotherapy Plus Radiotherapy and High-Dose-Rate Brachytherapy for FIGO Stage II and III Cervical Cancer. Asian Pac J Cancer Prev 2015;16(14): 5957-61.

Zhang Y, Yang Z, Zhou Y, Pan J, Liu Y. Efficacy of concurrent single-agent chemotherapy using radiotherapy in patients with cervical cancer: a meta-analysis. Int J ClinExp Med 2015;8(6): 8661-73.

Fu ZZ, Li K, Peng Y, Zheng Y, Cao LY, Zhang YJ et al. Efficacy and toxicity of different concurrent chemoradiotherapy regimens in the treatment of advanced cervical cancer: A network meta-analysis. Medicine (Baltimore) 2017;96(2): e5853.

Depuydt CE, Beert J, Bosmans E, Salembier G. Human Papillomavirus (HPV) virion induced cancer and subfertility, two sides of the same coin. Facts Views Vis Obgyn 2016;8(4): 211-2.

Meng XY, Liao Y, Liu XP, Li S, Shi MJ, Zeng XT. Concurrent cisplatin-based chemoradiotherapy versus exclusive radiotherapy in high-risk cervical cancer: a meta-analysis. Onco Targets Ther 2016;9:1875-88.

Krusun S, Pesee M, Supakalin N, Thamronganantasakul K, Supaadirek C,Padoongcharoen P. Treatment interruption during concurrent chemoradiotherapy of uterine cervical cancer; analysis of factors and outcomes. Asian Pac J Cancer Prev 2014;15(14): 5653-7.

PP Royal-Preyra B, Bowes D, Bahl G, Joseph P, Nolan M, Ymeri H et al. Long-term Outcomes and Late Effects of Definitive Chemoradiotherapy in Patients with Cervical Cancer in Nova Scotia. Cureus 2015;7(10): e343.

Liu Y, Yu J, Qian L, Zhang H, Ma J. Extended field intensity-modulatedradiotherapy plus concurrent neda-platin treatment in cervical cancer. Oncol Lett 2016;11(5):3421-7.PP

FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. International Journal of Gynecology and Obstetrics 2009;105: 103–4.

Li Z, Yang S, Liu L, Han S. A comparison of concurrent chemoradiotherapy and radiotherapyin Chinese patients with locally advanced cervical carcinoma: a multi-center study. Radiat Oncol 2014;9: 212.

Kalaghchi B, Abdi R, Amouzegar-Hashemi F, Esmati E, Alikhasi A. Concurrent Chemoradiation with Weekly Paclitaxel and Cisplatin for Locally Advanced Cervical Cancer. Asian Pac J Cancer Prev 2016;17(S3):287-91.

Mazeron R, Gilmore J, Dumas I, Champoudry J, Gou-lart J, Vanneste B et al. Adaptive 3D image-guided brachytherapy: a strong argument in the debate on systematic radical hysterectomy for locally advanced cervical cancer. Oncologist 2013;18(4): 415-22.

Reducing Uncertainties About the Effects of Chemoradiotherapy for Cervical Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data From 18 Randomized Trials Chemoradiotherapy for Cervical Cancer Meta-Analysis Collaboration J Clin Oncol 2008; 26(35): 5802–12.

Yoon HI, Cha J, Keum KC, Lee HY, Nam EJ, Kim SW et al. Treatment outcomes of extended-field radiation therapy and the effect of concurrent chemotherapy on uterine cervical cancer with para-aortic lymph node metastasis. Radiat Oncol 2015; 10:18.

Chen CC, Wang L, Lin JC, Jan JS. The prognostic fac-tors for locally advanced cervical cancer patients treated by intensity-modulated radiation therapy with concurrent chemotherapy. J Formos Med Assoc 2015;114(3): 231-7.

Kirwan JM, Symonds P, Green JA, Tierney J, Collingwood M, Williams CJ. A systematic review of acute and late toxicity of concomitant chemoradiation for cervical cancer. Radiother Oncol 2003;68(3): 217-26.

Dutta S, Nguyen NP, Vock J, Kerr C, Godinez J, Bose S et al. International Geriatric Radiotherapy Group. Image-guided radiotherapy and -brachytherapy for cer-vical cancer. Front Oncol 2015;5:64.

Kaidar-Person O, Abdah-Bortnyak R, Amit A, Nevelsky A, Berniger A, Bar-Deroma R et al. Tolerance of the vaginal vault to high-dose rate brachytherapy and concomitant chemo-pelvic irradiation: Long-term perspective. Rep Pract Oncol Radiother 2013;19(1):56-61.

Petit A, Floquet A, Lasbareilles O, Stoeckle E, Chemin A, Kind M et al. Pulsed-dose-rate brachytherapy for uterine cervix carcinoma: 10 years of experience with 226 patients at a single institution. Brachytherapy 2013;12(6): 542-9.

Viswanathan AN, Beriwal S, De Los Santos JF, Dema-nes DJ, Gaffney D, Hansen J et al; American Brachytherapy Society. American Brachytherapy Society consensus guidelines for locally advanced car-cinoma of the cervix. Part II: high-dose-rate brachytherapy. Brachytherapy 2012;11(1):47-52.

Haie-Meder C, Pötter R, Van Limbergen E, Briot E, De Brabandere M, Dimopoulos J et al; Gynaecological (GYN) GEC-ESTRO Working Group. Recommenda-tions from Gynaecological (GYN) GEC-ESTRO Working Group (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol 2005;74(3):235-45.

Diaz J, Yu D, Micaily B, Ferriss JS, Hernandez E. Radiation therapy with concurrent chemotherapy for locally advanced cervical carcinoma: outcome analysis with emphasis on the impact of treatment duration on outcome. Obstet Gynecol Int 2014;2014:214351.

Pathy S, Kumar L, Pandey RM, Upadhyay A, Roy S, Dadhwal V et al. Impact of Treatment Time on Chemoradiotherapy in Locally Advanced Cervical Carcinoma. Asian Pac J Cancer Prev 2015;16(12):5075-9.

Roszak A, Wareńczak-Florczak Z, Bratos K, Milecki P. Incidence of radiation toxicity in cervical cancer and endometrial cancer patients treated with radiotherapy alone versus adjuvant radiotherapy. Rep Pract Oncol Radiother 2012;17(6): 332-8.

Halperin E, Wazer D, Perez C, Brady L. Perez and Brady’s Principles and Practice of radiation oncology. Sixth edition. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins 2013.

PJ Zhou J, Chen QH, Wu SG, He ZY, Sun JY, Li FY et al. Lymph node ratio may predict the benefit of postoperative radiotherapy in node-positive cervical cancer. Oncotarget 2016;7(20): 29420-8.

Cihoric N, Tapia C, Krüger K, Aebersold DM, Klaeser B, Lössl K. IMRT with FDG-PETCT based simulta-neous integrated boost for treatment of nodal positive cervical cancer. Radiat Oncol 2014;9:83.

Liberman D, Mehus B, Elliott SP. Urinary adverse effects of pelvic radiotherapy. Transl Androl Urol 2014;3(2): 186-95.

Hernández-Moreno A, Vidal-Casariego A, Calleja-Fer-nández A, Kyriakos G, Villar-Taibo R, Urioste-Fondo A et al. Chronic enteritis in patients undergoing pelvic radiotherapy: prevalence, risk faktors and associated complications. Nutr Hosp 2015; 32(5): 2178-83.

Qin Q, Huang Q, Zhong Q, Fan X, Chen D, Wang L. Clinical risk factors for late intestinal toxicity after radiotherapy: A systematic review protocol. Syst Rev 2013;2:39.

Varghese SS, Ram TS, Pavamani SP, Thomas EM, Jeyaseelan V, Viswanathan PN. Concurrent chemo-irradiation with weekly cisplatin and paclitaxel in the treatment of locally advanced squamous cell carcinoma of cervix: a phase II study. J Cancer Res Ther 2014;10(2): 330-6.

Muecke R, Micke O, Schomburg L, Buentzel J, Glatzel M, Baaske D еt al. Impact of treatment planning target volumen (PTV) size on radiation induced diarrhoea following selenium supplementation in gynecologic radiation oncology--a subgroup analysis of a multi-center, phase III trial. Radiat Oncol 2013; 8:72.

PJ Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995;31(5): 1341-6.

PJ National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Servi-ces. Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. Revised Version 4.03 June, 2010.

Chinnachamy AN, Chopra S, Krishnatry R, Kannan S, Thomas B, Mahantshetty U et al. Evaluation of inte-robserver and interscale agreement in assessing late bowel toxicity after pelvic radiation in patients with carcinoma of the cervix. Jpn J Clin Oncol 2013;43(5): 508-14.

Kerns SL, Kundu S, Oh JH, Singhal SK, Janelsins M, Travis LB et al. The Prediction of Radiotherapy Toxicity Using Single Nucleotide Polymorphism-Based Models: A Step Toward Prevention. Semin Radiat Oncol 2015;25(4): 281-91.

Kuku S, Fragkos C, Mc Cormack M, Forbes A. Radia-tion-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers. Br J Cancer 2013;109(6): 1504-12.

Bentzen SM. Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nat Rev Cancer 2006;6: 702–13.

Huscher A, Bignardi M, Magri E, Vitali E, Pasinetti N, Costa L et al. Determinants of small bowel toxicity in postoperative pelvic irradiation for gynaecological malignancies. Anticancer Res 2009;29(11): 4821-6.

Beskow C, Agren-Cronqvist AK, Lewensohn R, Toma-Dasu I. Biological effective dose evaluation and assessment of rectal and bladder complications for cer-vical cancer treated with radiotherapy and surgery. J Contemp Brachytherapy 2012;4(4): 205-12.

Tharavichtikul E, Meungwong P, Chitapanarux T, Cha-krabandhu S, Klunklin P, Onchan W et al. The association of rectal equivalent dose in 2 Gy fractions (EQD2) to late rectal toxicity in locally advanced cer-vical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University. Radiat Oncol J 2014;32(2): 57-62.

Julie DA, Oh JH, Apte AP, Deasy JO, Tom A, Wu AJ et al. Predictors of acute toxicities during definitive chemoradiation using intensity-modulated radiotherapy for anal squamous cell carcinoma. Acta Oncol 2016;55(2): 208-16.

Ferrigno R, Santos A, Martins LC, Weltman E, Chen MJ, Sakuraba R et al. Comparison of conformal and intensity modulated radiation therapy techniques for treatment of pelvic tumors. Analysis of acute toxicity. Radiat Oncol 2010;5:117.

Xu B, Guo Y, Chen Y, Lu H, Tang T, Yue Z et al. Is the irradiated small bowel volume still a predictor for acute lower gastrointestinal toxicity during preoperative concurrent chemo-radiotherapy for rectal cancer when using intensity-modulated radiation therapy? Radiat Oncol 2015;10:257.

Marnitz S, Wlodarczyk W, Neumann O, Koehler C, Weihrauch M, Budach V. Which technique for radiation is most beneficial for patients with locally advanced cervical cancer? Intensity modulated proton therapy versus intensity modulated photon treatment, helical tomotherapy and volumetric arc therapy for primary radiation - an intraindividual comparison. Radiat Oncol 2015;10:91.

Chopra S, Dora T, Chinnachamy AN, Thomas B, Kan-nan S, Engineer R et al. Predictors of grade 3 or higher late bowel toxicity in patients undergoing pelvic radia-tion for cervical cancer: results from a prospective study. Int J Radiat Oncol Biol Phys 2014;88(3):630-5.

Jereczek-Fossa BA, Badzio A, Jassem J. Factors deter-mining acute normal tissue reactions during postopera-tive radiotherapy in endometrial cancer: analysis of 317 consecutive cases. Radiother Oncol. 2003;68(1):33-9.

Hafiz A, Abbasi AN, Ali N, Khan KA, Qureshi BM. Frequency and Severity of Acute Toxicity of Pelvic Radiotherapy for Gynecological Cancer. J Coll Physicians Surg Pak 2015;25(11):802-6.

Chen SW, Liang JA, Hung YC, Yeh LS, Chang WC, Lin WC et al. Late toxicities in concurrent chemoradiotherapy using high-dose-rate intracavitary brachytherapy plus weekly cisplatin for locally advanced cervical cancer: a historical cohort comparison against two previous different treatment schemes. Eur J Gynaecol Oncol 2010;31(5):504-9.

Huang EY, Sung CC, Ko SF, Wang CJ, Yang KD. The different volume effects of small-bowel toxicity during pelvic irradiation between gynecologic patients with and without abdominal surgery: a prospective study with computed tomography-based dosimetry. Int J Radiat Oncol Biol Phys 2007;69(3):732-9.

Yang TJ, Oh JH, Son CH, Apte A, Deasy JO, Wu A et al. Predictors of acute gastrointestinal toxicity during pelvic chemoradiotherapy in patients with rectal cancer. Gastrointest Cancer Res 2013;6(5-6):129-36.

Noyes WR, Hosford CC, Schultz SE. Human collagen injections to reduce rectal dose during radiotherapy. Int J Radiat Oncol Biol Phys 2012;82(5):1918-22.

Chopra S, Krishnatry R, Dora T, Kannan S, Thomas B, Sonawone S et al. Predictors of late bowel toxicity using three different methods of contouring in patients undergoing post-operative radiation for cervical cancer. The Br J Radiol 2015;88(1055):20150054.

Kumaran A, Guruvare S, Sharan K, Rai L, Hebbar S. Chemoradiation related acute morbidity in carcinoma cervix and correlation with hematologic toxicity: a South Indian prospective study. Asian Pac J Cancer Prev 2014;15(11): 4483-6.

Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P et al. Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet 1997;350(9077): 535-40.

Gangopadhyay A, Das J, Nath P, Biswas J. Haemoglo-bin levels may predict toxicities in patients on pelvic chemoradiation for carcinoma of the cervix-experience of a regional cancer centre. E cancer medical science 2014;8:431.

PJ Dandapani SV, Zhang Y, Jennelle R, Lin YG. Radiation-Associated Toxicities in Obese Women with Endometrial Cancer: More Than Just BMI? Scientific World Journal 2015;2015:483208.

Ha Smits A, Mc Grane J, Lopes A, Kent E, Bekkers R, Massuger L et al. Radiation-related toxicities and out-comes in endometrial cancer: are obese women at a disadvantage? Int J Clin Oncol 2017.

Klopp AH, Moughan J, Portelance L, Miller BE, Saleh-pour MR, Hildebrandt E et al. Hematologic toxicity in RTOG 0418: a phase 2 study of postoperative IMRT for gynecologic cancer. Int J Radiat Oncol Biol Phys. 2013;86(1): 83-90.

Carmona R, Pritz J, Bydder M, Gulaya S, Zhu H, Williamson CW et al. Fat composition changes in bone marrow during chemotherapy and radiation therapy. Int J Radiat Oncol Biol Phys 2014;90(1):155-63.

Singh D, Latha H, Kapoor A, Mayilvaganan A, Jakhar SL, Kumar HS. Necessity of CT-MRI based treatment planning for cervical tumors with retroverted uterus: A case report with review of literature. J Cancer Res Ther 2015;11(3):662.

Chakraborty S, Geetha M, Dessai S, Patil VM. How well do elderly patients with cervical cancer tolerate definitive radiochemotherapy using RapidArc? Results from an institutional audit comparing elderly versus younger patients. E cancer medical science 2014;8: 484.

Tharavichitkul E, Wanwilairat S, Chakrabandhu S, Klunklin P, Onchan W, Tippanya D et al. Image-guided brachytherapy (IGBT) combined with whole pelvic intensity-modulated radiotherapy (WP-IMRT) for locally advanced cervical cancer: a prospective study from Chiang Mai University Hospital, Thailand. J Contemp Brachytherapy 2013;5(1): 10-6.

Sagae S, Monk BJ, Pujade-Lauraine E, Gaffney DK, Narayan K, Ryu SY et al; Gynecologic Cancer Inter-Group Cervix Cancer brainstorming day. Advances and Concepts in Cervical Cancer Trials: A Road Map for the Future. Int J Gynecol Cancer 2016;26(1): 199-207.

Orecchia R, Surgo A, Muto M, Ferrari A, Piperno G, Gerardi MA et al. VERO® radiotherapy for low burden cancer: 789 patients with 957 lesions. E cancer medical science 2016;10: 677.

Narayan K, van Dyk S, Bernshaw D, Khaw P, Milesh-kin L, Kondalsamy-Chennakesavan S. Ultrasound gui-ded conformal brachytherapy of cervix cancer: survival, patterns of failure, and late complications. J Gynecol Oncol 2014;25(3): 206-13.

Basu S, Manir KS, Basu A, Ghosh K. Rectal separation using hydroxypropyl methylcellulose in intracavitary brachytherapy of cervical cancer: an innovative appro-ach. J Contemp Brachytherapy 2016;8(5): 399-403.

Chai Y, Wang J, Gao Y, Wang T, Shi F, Su J et al.Identification of biomarkers for radiation-induced acute intestinal symptoms (RIAISs) in cervical cancer patients by serum protein profiling. J Radiat Res 2015;56(1): 134-40.

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2019/02/17
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