Late radiation-related toxicities in women treated for cervical carcinoma for the year 2002 to 2006: in a tertiary hospital

Ana Sheila Gonzales. M.D.

Background: In the Philippines, the most common cancer of the female reproductive system is cervical cancer. Radiation therapy is an important part of treatment for cervical cancer. However, the effects of radiation gradually accumulate and long-term sequelae can be seen at variable intervals following radiation treatment. The risk of developing complications depends on patient co-morbidities, previous surgical procedures and amount of radiation received. Presently, there is little local data on late radiation toxicities among patients with cervical carcinoma. This study aims to describe late organ toxicities in patients with cervical cancer treated with radiation therapy in a local tertiary hospital.

Methods: Records of cervical cancer patients who underwent radiotherapy from 2002-2006 at St. Luke’s Medical Center were reviewed. Patient profile, type and dose of radiation and morbidity were compiled and described.

Results: Medical records of 127 patients were reviewed. The median External Beam Radiation Therapy dose was 48.8 Gy while the median Brachytherapy dose was 26.6 Gy. The risk of late injury were found among stage IIB patients (28%) and in squamous cell carcinoma type disease (37%). Twelve (55%) patients who had concurrent chemoradiation developed late complications in the rectum, genitourinary tract and vagina.

Conclusion: The goal of  treatment for cervical cancer is to optimize the EBRT and brachytherapy components. Rectum and genitourinary late-radiation related toxicities were comparable to literature. Serious complications within the vaginal vault were documented.