Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Medicina (Kaunas). 2024 Aug 21;60(8):1364. doi: 10.3390/medicina60081364.
: This study aimed to investigate the clinical course and characteristics of late toxicity over time following the completion of definitive radiotherapy (RT) in patients with cervical cancer. : We retrospectively reviewed the medical records of 60 patients with cervical cancer who underwent pelvic external beam radiotherapy followed by intracavitary brachytherapy. Late toxicity was assessed for the lower gastrointestinal (GI) tract and bladder organ at 6, 12, 24, 36, and >36 months post-RT. We examined the onset and prevalence of late toxicity at each time point. Clinical remission and interventions for managing late toxicity were also investigated. : The peak onset of lower GI toxicity occurred 12 months after RT completion, with a median symptom duration of 9.9 months (range, 0.1-26.3 months), and exhibited its highest prevalence rate of 15.5% at 24 months post-RT. Most GI toxicities developed and resolved within three years post-RT, with a prevalence rate of 8.1% at three years, followed by a decreasing trend. Bladder toxicity first peaked at 24 months post-RT and continued to occur beyond 36 months, showing the re-increasing pattern in the prevalence rate after 36 months (23.5%). In terms of clinical remission, 66.7% of lower GI toxicities (12 of 18 patients) and 60% of bladder toxicities (9 of 15 patients) achieved complete remission by the last follow-up date. : Late toxicities of the GI and bladder following definitive RT in cervical cancer are partially reversible and exhibit distinct patterns of onset and prevalence over time. A systematic follow-up strategy should be established for the early detection and timely intervention of late toxicity by understanding these clinical courses.
: 本研究旨在探讨宫颈癌根治性放疗（RT）后随时间推移的晚期毒性的临床过程和特征。: 我们回顾性分析了 60 例接受盆腔外照射放疗联合腔内近距离放疗的宫颈癌患者的病历。在 RT 后 6、12、24、36 和 >36 个月时，评估下胃肠道（GI）和膀胱器官的晚期毒性。我们检查了每个时间点晚期毒性的发病和流行情况。还研究了临床缓解和管理晚期毒性的干预措施。: 下 GI 毒性的发病高峰出现在 RT 完成后 12 个月，中位症状持续时间为 9.9 个月（范围 0.1-26.3 个月），在 RT 后 24 个月时达到最高流行率 15.5%。大多数 GI 毒性在 RT 后 3 年内发展和缓解，3 年后的流行率为 8.1%，随后呈下降趋势。膀胱毒性在 RT 后 24 个月首次达到高峰，并持续至 36 个月后，在 36 个月后呈现流行率增加的趋势（23.5%）。就临床缓解而言，18 例下 GI 毒性患者中有 12 例（66.7%）和 15 例膀胱毒性患者中有 9 例（60%）在最后随访日期达到完全缓解。: 宫颈癌根治性放疗后 GI 和膀胱的晚期毒性部分是可逆的，且具有随时间推移而呈现出不同的发病和流行模式。通过了解这些临床过程，应建立系统的随访策略，以便早期发现和及时干预晚期毒性。
