Review
№26 3 2024

POST-RADIATION COMPLICATIONS AS A FACTOR IN PREDICTING THE EFFECTIVENESS OF TREATMENT OF BODY AND CERVICAL CANCER

Keywords:
, , ,
Full article in PDF format
Views: 11

Yu.V. Dumanskyi¹, E.A. Domina1, O.Yu. Stoliarova², L.I. Makovetska¹.

¹RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, national Academy of Sciences of Ukraine,

²National Cancer Institute of Ukraine, Kyiv, Ukraine.

DOI: https://doi.org/10.15407/oncology.2024.03.165

Summary. Despite recent advances in the treatment of malignant neoplasms of the endometrium and cervix, in a certain part of patients after combined treatment, which includes radiation therapy, there are progressive radiation-induced radiation impressions of the pelvic organs. The presence of the latter and the degree of their expressiveness quite often require long-term care and treatment. Based on the analysis of literature data, the publication presents modern ideas about the factors that influence the development of post-radiation complications, their characteristics, and provides information about the conceptual features of changes occurring in the area of influence of radiation therapy.

Keywords: cervical cancer, uterine body cancer, radiotherapy, post-radiation complications.

 

References

  1. Cancer in Ukraine. Рак 2022 – Incidente, mortality, prevalence and other relevant statistics. Bulletin of the national cancer registry of Ukraine. Kyiv, 2024; 25. http://www.ncru.inf.ua/publications BULL_25/index.htm#hcr. Accessed June 07, 2024.
  2. Andreyev HJ, Vlavianos P, Blake P, et al. Gastrointestinal symptoms after pelvic radiotherapy: role for the gastroenterologist? Int J Radiat Oncol Biol Phys 2005; 62 (5):1464– doi: 10.1016/j.ijrobp.2004.12.087.
  3. Andreyev J. Gastrointestinal complications of pelvic radiotherapy: are they of any importance? Gut 2005; 54 (8): 1051– doi: 10.1136/gut.2004.062596.
  4. Kozelsky TF, Meyers GE, Sloan JA, et al. Phase III double-blind study of glutamine versus placebo for the prevention of acute diarrhea in patients receiving pelvic radiation therapy. J Clin Oncol 2003; 21 (9): 1669–74. doi: 10.1200/JCO.2003.05.060.
  5. Andreyev J. Gastrointestinal symptoms after pelvic radiotherapy: a new understanding to improve management of symptomatic patients. Lancet Oncol 2007; 8 (11):1007–17. doi: 10.1016/S1470-2045(07)70341-8.
  6. Haysenyuk L.O. Hematological aspects of complications of radiation and cytostatic therapy in cancer patients. Ukrainian Radiological Journal 2002; 10 (3): 265–70. (in Ukrainian).
  7. Klepper LYa. Probability of occurrence of radiation complications in an organ or tissue as a function of dose, volume of irradiation and dose fractionation scheme over time. Medical radiology and radiation safety 1997; 1: 47–51. (in Ukrainian).
  8. Barrilot I., Maingon P., Truc G., Horiot J. Complications of treatments of invasive cancers of the uterine cervix with intact uterus: results and prevention. Cancer / Radiother 2000; 4 (2): 147–58. https://doi.org/10.1016/S1278-3218(00)88899-X.
  9. Jhinngran A, Eifel PJ. Perioperative and postoperative complications of intracavitary radiation for FIGO stage I-Ш carcinoma of the cervix. Int J Radiat Oncol Biol Phys s 2000; 46 (5): 1177–83. doi: 10.1016/s0360-3016(99)00545-3.
  10. Rose PG. Chemoradiotherapy for cervical cancer. Eur J Cancer 2002; 38 (2): 270–8. doi: 10.1016/s0959-8049(01)00352-5.
  11. Wollschlaeger K, Connell PP, Waggoner S, et al. Acute problems during low-dose-rate intracavitary brachytherapy for cervical cartinoma. Gynec Oncol 2000; 76 (1): 67–72. doi: 10.1006/gyno.1999.5627.
  12. Granov AM, Vinokurov VL. Radiation therapy in oncogynecology and oncourology. St. Petersburg, 350 p.
  13. Ivanitskaya VI, Kislichenko VA, Gerinshtein IG, al. Complications of radiation therapy in cancer patients. Kyiv: Zdorovya, 1989. 182 p. (in Ukrainian).
  14. Mayadev J, Lim J, Durbin-Johnson B, al. Smoking decreases survival in locally advanced cervical cancer treated with radiation. Am J Clin Oncol 2018; 41 (3): 295–301. doi: 10.1097/COC.0000000000000268.
  15. Wang J, Hauer-Jensen M. Neuroimmune interactions: potential target for mitigating or treating intestinal radiation injury. Br J Radiol 2007; 80 (1): S41–8. doi: 10.1259/bjr/33057885.
  16. Semikoz NG, Shlopov VG. Radiation pathomorphosis of organs and tissues of the small pelvis in the treatment of cancer of the body and cervix of the uterus. Donetsk: Kitis, 2000. 152 p. (in Ukrainian).
  17. Gasinska A, Fowler JF, Lind BK, Urbanski K. Influence of overall treatment time and radiobiological parameters on biologically effective doses in cervical cancer patients treated with radiation therapy alone.Acta Oncol 2004; 43 (7): 657–66. doi: 10.1080/02841860410018511.
  18. Hamada K, Kihana T, Kataoka M. Urinary disturbance after therapy for cervical cancer: urodynamic evaluation and beta 2-agonist medication. Int Urogynecol J Pelvic Floor Dysfunct 1999; 10 (6): 365–70. doi: 10.1007/s001920050061.
  19. Semikoz NG. Clinical and morphological assessment and treatment complications of the received promenopausal therapy in cases of cancer of the female organs. Author’s abstract. dis. …doctor of medical sciences. Donetsk, 1999. 34 p. (in Ukrainian).
  20. Stolyarova IV. Optimization of radiation and combined treatment of patients with uterine cancer under conditions of modification of tumor radiosensitivity: Abstract of dis. … Doctor of Medical Sciences. St. Petersburg, 1995. 43 p. (in Ukrainian).
  21. Jilavyan G. Ways to improve the effectiveness of combined treatment of patients with cervical cancer. Abstract of the 2nd Congress of Oncologists of the CIS Countries. Kiev, 2000: (in Ukrainian).
  22. Semikoz NG. Cancer of female genital organs. Complications of combined radiation therapy and their treatment. Abstract of the 2nd Congress of Oncologists of the CIS Countries. Kiev, 2000: (in Ukrainian).
  23. Shin KN, Huh SJ, Chie EK, al. Analysis of correlation between rectal complications and rectal dose following high dose rate intracavitary radiotherapy in patients with uterine cervix cancer: in vivo dosimetric analysis. Radiat Med 1999; 17 (4): 289–93.
  24. Clinical Roentgenology (manual). Vol. 5. In: Radiation therapy of tumors and non-tumor diseases. Zedgenidze GA (ed). USSR Academy of Medical Sciences. M: Medicine, 1985. 496 p.
  25. Bardychev MS, Katsalap SN. Local radiation injuries: features of pathogenesis, diagnostics and treatment. Vopr Oncol 1995; 41 (2): 99.
  26. Vusik IM. Diagnostics and treatment of radiation ulcers of the bladder in patients with cervical cancer. Experimental and clinical radiology. Kyiv: Zdorov’ya, 1980: 71–6. (in Ukrainian).
  27. Rozenko LYa, Sidorenko YuS, Frantsiyants EM. Features of changes in the parameters of the antioxidant status of the blood of patients with cervical cancer in the dynamics of antitumor treatment. Vopr Oncol 1999; 45 (6): 630–35.
  28. LENT SOMA tables. Radiother Oncol 1995; 35 (1): 17–60. PMID: 7569012.
  29. Radiotherapy Oncology Group. Practical guidelines for clinical trials.1987: 38–
  30. Pilipenko MI, Tarasova OM. High-quality clinical practice. Ukrainian Radiological Journal 2002; 10 (3): 308-330. (in Ukrainian).
  31. Denham JW, Hauer-Jensen M, Peters LJ. Is it time for a new formalism to categorize normal tissue radiation injury? Int J Radiat Oncol Biol Phys 2001; 50 (5): 1105–6. doi: 10.1016/s0360-3016(01)01556-5.
  32. Bourne RG, Kearsley JH, Grove WD, Roberts SJ. The relationship between early and late gastrointestinal complications of radiation therapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 1983; 9 (10): 1445–50. doi: 10.1016/0360-3016(83)90316-4.
  33. Peters LJ, Ang KK, Thames Jr HD. Accelerated fractionation in the radiation treatment of head and neck cancer. A critical comparison of different strategies. Acta Oncol 1988; 27 (2): 185–94. doi: 10.3109/02841868809090339.
  34. Hauer-Jensen M, Denham JW, Andreyev HJ. Radiation enteropathy pathogenesis, treatment and prevention. Nat Rev Gastroenterol Hepatol 2014; 11 (8): 470–9. doi: 10.1038/nrgastro.2014.46.
  35. Andreyev HJ, Wotherspoon A, Denham JW, Hauer-Jensen M. ‘Pelvic radiation disease’: new understanding and new solutions for a new disease in the era of cancer survivorship. Scand J Gastroenterol 2011; 46: 389–97. 10.3109/00365521.2010.545832.
  36. Sims TT, Colbert LE, Zheng J, et al. Gut microbial diversity and genus-level differences identified in cervical cancer patients versus healthy controls. Gynecol Oncol 2019; 155 (2): 237–44. doi: 10.1016/j.ygyno.2019.09.002.
  37. Mitra A, Grossman Biegert GW, Delgado AY, et al. Microbial diversity and composition is associated with patient-reported toxicity during chemoradiation therapy for cervical cancer. Int J Radiat Oncol Biol Phys 2020;107 (1): 163–71. doi: 10.1016/j.ijrobp.2019.12.040.
  38. Nam YD, Kim HJ, Seo JG, et al. Impact of pelvic radiotherapy on gut microbiota of gynecological cancer patients revealed by massive pyrosequencing. PLoS One 2013; 8 (12): e doi: 10.1371/journal.pone.0082659.
  39. Manichanh C, Varela E, Martinez C, et al. The gut microbiota predispose to the pathophysiology of acute postradiotherapy diarrhea. Am J Gastroenterol 2008; 103 (7): 1754–61. doi: 10.1111/j.1572-0241.2008.01868.x.
  40. Ferreira MR, Muls A, Dearnaley DP, Andreyev HJ. Microbiota and radiation-induced bowel toxicity: lessons from inflammatory bowel disease for the radiation oncologist. Lancet Oncol 2014; 15 (3): e139–47. doi: 10.1016/S1470-2045(13)70504-7.
  41. Cui M, Xiao H, Li Y, et al. Sexual dimorphism of gut microbiota dictates therapeutics efficacy of radiation injuries. Adv Sci 2019; 6 (21): 1901048. doi: 10.1002/advs.201901048.
  42. Tedelind S, Westberg F, Kjerrulf M, Vidal A. Anti-inflammatory properties of the short-chain fatty acids acetate and propionate: a study with relevance to inflammatory bowel disease. World J Gastroenterol 2007; 13 (20): 2826– doi: 10.3748/wjg.v13.i20.2826.
  43. Segain JP, Raingeard de la Bleti ere D, Bourreille A, et al. Butyrate inhibits inflammatory responses through NFkappaB inhibition: implications for Crohn’s disease. Gut 2000; 47 (3): 397– doi: 10.1136/gut.47.3.397.
  44. Duboc H, Rajca S, Rainteau D, et al. Connecting dysbiosis, bile-acid dysmetabolism and gut inflammation in inflammatory bowel diseases. Gut 2013; 62 (4): 531– doi: 10.1136/gutjnl-2012-302578.
  45. Bowen R, Miller P, Shanahan MT, et al. Radiation exposure induces dysbioses throughout the small intestinal and colonic lumen and mucosa that resemble those seen in human inflammatory bowel diseases. Inflamm Bowel Dis 2011; 17: S86. doi:10.1097/00054725-201112002-00286.
  46. Morgan XC, Tickle TL, Sokol H, et al. Dysfunction of the intestinal microbiome in inflammatory bowel disease and treatment. Genome Biol 2012; 13 (9): R79. doi: 10.1186/gb-2012-13-9-r79.
  47. Tedelind S, Westberg F, Kjerrulf M, Vidal A. Anti-inflammatory properties of the short-chain fatty acids acetate and propionate: a study with relevance to inflammatory bowel disease. World J Gastroenterol 2007; 13 (20): 2826-32. doi: 10.3748/wjg.v13.i20.2826.
  48. Ploger S, Stumpff F, Penner GB, et al. Microbial butyrate and its role for barrier function in the gastrointestinal tract. Ann N Y Acad Sci 2012; 1258: 52– doi: 10.1111/j.1749-6632.2012.06553.x.
  49. Hsiao WW, Metz C, Singh DP, Roth J. The microbes of the intestine: an introduction to their metabolic and signaling capabilities. Endocrinol Metab Clin North Am 2008; 37 (4): 857– doi: 10.1016/j.ecl.2008.08.006
  50. Al–Qadami G, Van Sebille Y, Le H, Bowen J. Gut microbiota: implications for radiotherapy response and radiotherapyinduced mucositis. Expert Rev Gastroenterol Hepatol 2019; 13 (5): 485–96. doi: 10.1080/17474124.2019.1595586.
  51. Bentzen S.M., Overgaard J. Clinical manifestation of normal tissue damage. In: Basic Clinical Radiobiology. Ed. by Steel GG (ed). London, 2001: 87-97.
  52. Westin SN, Sun CC, Tung CS, et al. Survivors of gynecologic malignancies: impact of treatment on health and well-being. J Canc Surviv 2016; 10 (2): 261–70. doi: 10.1007/s11764-015-0472-9.
  53. Kirwan JM, Symonds P, Green JA, et al. A systematic review of acute and late toxicity of concomitant chemoradiation for cervical cancer. Radiother Oncol 2003; 68 (3): 217–26. doi: 10.1016/s0167-8140(03)00197-x.
  54. Kokka F, Bryant A, Brockbank E, Jeyarajah A. Surgical treatment of stage IA2 cervical cancer. Cochrane Database Syst Rev 2014; 5: doi: 10.1002/14651858.CD010870.pub2.
  55. Makovetska LI, Domina E.A. Prospects of the use of melatonin in radiation therapy Oncology 2024; 99 (1): 5– doi: https://doi.org/10.15407/oncology.2024.01.005. (in Ukrainian).
  56. Gallagher MJ, Brereton HD, Rostock RA, et al. A prospective study of treatment techniques to minimize the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation. Int J Radiat Oncol Biol Phys 1986; 12 (9): 1565– doi: 10.1016/0360-3016(86)90279-8.
  57. Powell ME. Modern radiotherapy and cervical cancer. Int J Gynecol Canc 2010; 20 (11, 2): S49–S51. doi: 10.1111/igc.0b013e3181f7b241.
  58. Lin Y, Chen K, Lu Z, et al. Intensitymodulated radiation therapy for definitive treatment of cervical cancer: a meta-analysis. Radiat Oncol 2018; 13 (1): 177. doi: 10.1186/s13014-018-1126-7.
  59. Bardychev MS. Radiation injuries. In: Radiation therapy of malignant neoplasms. Kiseleva ES (ed). M: Medicine, 1996: 437–
  60. Kiseleva ES, Goldobenko GV, Kanaev SV, et al. Radiation therapy of malignant tumors. Manual for doctors. Kiseleva ES (ed). M: Medicine, 1996. 464p.
  61. Kozelsky TF, Meyers GE, Sloan JA, et al. Phase III double-blind study of glutamine versus placebo for the prevention of acute diarrhea in patients receiving pelvic radiation therapy. J Clin Oncol 2003; 21 (9): 1669– doi: 10.1200/JCO.2003.05.060.
  62. Bacon CG, Giovannucci E, Testa M, et al. The association of treatment-related symptoms with quality-oflife outcomes for localized prostate carcinoma patients. Cancer 2002; 94 (3): 862–71. doi: 10.1002/cncr.10248.
  63. Andreyev HJ. Gastrointestinal problems after pelvic radiotherapy: the past, the present and the future. Clin Oncol 2007; 19 (10): 790– doi: 10.1016/j.clon.2007.08.011.
  64. Faithfull S. ‘Just grin and bear it and hope that it will go away’: coping with urinary symptoms from pelvic radiotherapy. Eur J Canc Care 1995; 4 (4): 158– doi: 10.1111/j.1365-2354.1995.tb00087.x.
  65. Gami B, Harrington K, Blake P, et al. How patients manage gastrointestinal symptoms after pelvic radiotherapy. Aliment Pharmacol Ther 2003; 18 (10): 987– doi: 10.1046/j.1365-2036.2003.01760.x.
  66. Capp A, Inostroza–Ponta M, Bill D, et al. Is there more than one proctitis syndrome? A revisitation using data from the TROG 96.01 trial. Radiother Oncol 2009; 90(3):400– doi: 10.1016/j.radonc.2008.09.019.
  67. Gilbert A, Sebag-Montefiore D, Davidson S, Velikova G. Use of patient-reported outcomes to measure symptoms and health related quality of life in the clinic. Gynecol Oncol 2015; 136 (3): 429–39. doi: 10.1016/j.ygyno.2014.11.071.
  68. Tom A, Bennett AV, Rothenstein D, et al. Prevalence of patient-reported gastrointestinal symptoms and agreement with clinician toxicity assessments in radiation therapy for anal cancer. Qual Life Res 2018; 27 (1): 97– doi: 10.1007/s11136-017-1700-8.
  69. Dyomina EA, Makovetska LI, Grinchenko OО, et al. Practical approaches to identifying endometrial cancer patients with an increased risk of radiation therapy complications based on predictors of radiosensitivity of cells from around the tumor. Recommendation method. Ministry of Health of Ukraine. Kyiv, 2021. 28 p. (in Ukrainian).
  70. Domina EA, Dumanskyi YV. Medical and radiobiological aspects of radiation complications in patients with an oncogynecological profile. Oncology 2023; 25 (1): 8–15. doi: https://doi.org/10.15407/oncology.2023.01.009. (in Ukrainian).

 

 

Статьи по теме:

  1. CLINICAL/MORPHOLOGICAL AND MOLECULAR BIOLOGICAL PROGNOSTIC FACTORS IN CERVICAL CANCER
  2. CERVICAL CANCER IN PREGNANCY: A MODERN GUIDELINE AND A VECTOR FOR THE DEVELOPMENT OF THERAPEUTIC APPROACHES
No comments » Add comment

Publishing House “Akademperiodyka” Apteka online Компендиум — справочник лекарств №1 Chasopys online Oncology