Hafiz Asim, Abbasi Ahmed Nadeem, Ali Nasir, Khan Khurshid Ahmed, Qureshi Bilal Mazhar
Department of Oncology, Section of Radiation Oncology, The Aga Khan University Hospital, Karachi.
J Coll Physicians Surg Pak. 2015 Nov;25(11):802-6.
To determine the frequency and severity of acute toxicity of pelvic radiotherapy for gynecological cancer.
A case series.
Department of Oncology, The Aga Khan University Hospital, Karachi, from March 2011 to June 2012.
A total of 99 patients with histologically proven uterine and cervical cancer, receiving radiation therapy, were enrolled into the study after informed consent on justification of inclusion and exclusion criteria. Patients were evaluated for the frequency and severity of pelvic radiotherapy’s side effects according to toxicity criteria based on RTOG/EORTC and CTC version 2 criteria at the start, during and at the end of treatment. The data was analyzed by using SPSS version 16.
Out of the 99 enrolled patients, 58 (58.6%) had uterine and 41 (41.4%) had cervical cancer. Mean age was 54.54 ± 10.29 years. Thirty-five (35.4%) patients received chemotherapy with RT. Mean RT dose was 60.72 ± 7.15 Gy. The most common gastrointestinal adverse effect was diarrhea in 64 (64.6%) followed by proctitis in 55 (55.5%), nausea in 33 (33.3%) and vomiting in 16 (16.2%) patients. Grade (G) 1 was the most frequently observed severity. The most common hematological toxicity was anemia in 37.8% (n=31/82) {(G1=18 (21.9%), G2=11 (13.4%), G3=2 (2.4%)} followed by thrombocytopenia in 22.8% (21/92) {(G1=16 (17.3%), G2=2 (2.1%), G3=3 (3.2%)} and neutropenia in 21 (21.2%) {(G1=12 (12.1%), G2=5 (5%), G3=3 (3%), G4=1 (1%)}. Urinary toxicity was observed in 49 (49.5%) patients. On stratification, chemotherapy and higher RT dose were strong predictor of increased hematological and upper gastrointestinal toxicity (p < 0.05) and age > 60 years for diarrhea (p < 0.05).
The frequency and severity of acute toxicity of pelvic radiotherapy in women with gynecologic cancers was found intermediate to high.
确定妇科癌症盆腔放疗急性毒性的发生率和严重程度。
病例系列研究。
2011年3月至2012年6月，卡拉奇阿迦汗大学医院肿瘤科。
共有99例经组织学证实的子宫癌和宫颈癌患者在获得关于纳入和排除标准的知情同意后纳入本研究，这些患者正在接受放射治疗。根据基于RTOG/EORTC和CTC第2版标准的毒性标准，在治疗开始时、治疗期间和治疗结束时对患者盆腔放疗副作用的发生率和严重程度进行评估。使用SPSS 16版软件对数据进行分析。
99例纳入患者中，58例（58.6%）患有子宫癌，41例（41.4%）患有宫颈癌。平均年龄为54.54±10.29岁。35例（35.4%）患者在放疗的同时接受了化疗。平均放疗剂量为60.72±7.15 Gy。最常见的胃肠道不良反应是腹泻，共64例（64.6%），其次是直肠炎55例（55.5%）、恶心33例（33.3%）和呕吐16例（16.2%）。1级是最常观察到的严重程度。最常见的血液学毒性是贫血，发生率为37.8%（n=31/82）{1级=18例（21.9%），2级=11例（13.4%），3级=2例（2.4%）}，其次是血小板减少症，发生率为22.8%（21/92）{1级=16例（17.3%），2级=2例（2.1%），3级=3例（3.2%）}，中性粒细胞减少症21例（21.2%）{1级=12例（12.1%），2级=5例（5%），3级=3例（3%），4级=1例（1%）}。49例（49.5%）患者出现泌尿系统毒性。分层分析显示，化疗和较高的放疗剂量是血液学和上消化道毒性增加的有力预测因素（p<0.05），年龄>60岁是腹泻的预测因素（p<0.05）。
妇科癌症女性盆腔放疗急性毒性的发生率和严重程度为中度至高度。
