Advanced cervical cancer in young women: Imaging study of late and very late radiation-related side effects after successful treatment by combined radiotherapy

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F21%3A43920832" target="_blank" >RIV/00216208:11120/21:43920832 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11130/21:10418338 RIV/00064173:_____/21:N0000019

Result on the web

<a href="https://doi.org/10.21037/QIMS-20-553" target="_blank" >https://doi.org/10.21037/QIMS-20-553</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.21037/QIMS-20-553" target="_blank" >10.21037/QIMS-20-553</a>

Result language

angličtina

Original language name

Advanced cervical cancer in young women: Imaging study of late and very late radiation-related side effects after successful treatment by combined radiotherapy

Original language description

Background: Radical combined radiotherapy (RT) is a standard treatment for advanced cervical cancer. The aim of our study was to identify morphological late (&gt;=6 months) and very late (&gt;=5 years) radiation-related comorbidities on computed tomography (CT), positron emission tomography/computerized tomography (PET/CT) or magnetic resonance imaging (MRI) scans in young females who survived &gt;=5 years since RT and were considered as successfully treated. Secondly, we studied a rate of clinically silent radiation-related toxicities apparent on imaging scans that might influenced on future well-being of survived females. Thirdly, we analyzed reasons why patients underwent imaging scans. Methods: We included 41 subjects aged under 50 years (mean 41.8+-7.2 years, median 41 years), who survived &gt;=5 years since RT, with at least one available imaging scan &gt;=3 years since RT. The mean time between RT and the last available scan was 12.3+-7.9 years (median 9 years); the mean time of clinical followup was 15.4+-7.1 years (median 14 years). Results: Fourteen (34.1%) females underwent the first imaging scan in emergency situation and 27 (65.9%) patients due to variable chronic complaints. Grade III-V radiation-related comorbidities occurred in 19 (46.3%) females including one case of death due to radiation-induced osteosarcoma. In 14 of 19 patients, comorbidities were multiple. Four (9.8%) females suffered from life-threatening complications (grade IV): one from an uretero-arterial fistula with massive hematuria and 3 from bowel perforations. Eleven (26.8%) subjects suffered from bowel strictures with ileus development, they underwent mean 1.7+-0.8 surgery (median 1.5). The mean time since RT to the first surgery for intestinal complications was 5.4+-6.0 years (median 3 years), to the second 12.0+-9.6 years (median 11.5 years) and to the third surgery 9.0+-4.2 years (median 9 years). Late fistulas formations (vesico-recto-vaginal) were seen in 6 (14.6%) patients. Bone complications were diagnosed in 9 (22.0%) of treated females, one case of osteosarcoma included, 4 of 9 bone complications were clinically silent. In 5 (12.2%) subjects, toxicities grade III-IV first time manifested &gt;5 years since RT, majority of them were multiple. The bowel perforation and fistulas formations were the earliest manifested grade III-IV toxicities, with median time 3 years since RT, the bone complications were the latest manifested with median time 16 years since RT. Conclusions: Our study is not able to bring information about the incidence of late and very late radiation related comorbidities, according to International Federation of Gynecology and Obstetrics (FIGO) recommendations patients are clinically followed only for 5 years and imaging cross-sectional scans are not recommended. However, our study shows that if females successfully treated for advanced cervical cancer report abdominal/pelvic clinical problems, it is highly probable their imaging scans will reveal late radiation related side-effects that may affect the rest of their life. It puts forward question whether females after radical RT should been regularly followed by cross-sectional imaging methods.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30224 - Radiology, nuclear medicine and medical imaging

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Quantitative Imaging in Medicine and Surgery

ISSN

2223-4292

e-ISSN

—

Volume of the periodical

11

Issue of the periodical within the volume

1

Country of publishing house

CN - CHINA

Number of pages

11

Pages from-to

21-31

UT code for WoS article

000598756100003

EID of the result in the Scopus database

2-s2.0-85096820056