AUTHOR=Nadova Katarina , Burghardtova Miroslava , Fejfarova Klara , Reginacova Klaudia , Malikova Hana 

TITLE=Late Radiation–Related Toxicities in Patients Treated for Early-Stage Cervical Carcinoma by Surgery and Adjuvant Radiotherapy: A Retrospective Imaging Study

JOURNAL=Pathology and Oncology Research

VOLUME=Volume 27 - 2021

YEAR=2021

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2021.1609915

DOI=10.3389/pore.2021.1609915

ISSN=1532-2807

ABSTRACT=Surgical treatment is preferred therapy of early-stage cervical carcinoma. In the risk of
cancer recurrence surgery is often followed by adjuvant radiotherapy. In our retrospective
study we aimed at identifying late (≥6 months) and very late (≥5 years) radiation adverse
effects on imaging scans as CT, PET/CT and MRI in patients who underwent successful
treatment for cervical carcinoma by radical surgery combined with radiotherapy ±
chemotherapy. We correlated imaging results with clinical manifestations. We selected young
and middle-aged patients with long life expectancy, as late radiation-related toxicities may
significantly affect their quality of life.

Patients were selected from those who were primary diagnosed and treated between
the years 1987 – 2011 and regularly visited our Oncology department in years 2011–
2012.treated at our oncology department in 2011–2012 according to Following inclusion
criteria were applied: age ≤55 years at diagnosis, clinical follow-up ≥5 years and at least one
tomography scan ≥3 years after finished treatment. One hundred and three subjects were
reviewed: 73 patients met all inclusion criteria, while 30 patients fulfilled the inclusion
criteria except for available tomography scan ≥ 3 years after therapy.

The mean imaging follow-up was 11.2 ± 7.6 years and the mean clinical follow-up
was 15.0 ± 6.9 years. In 20 (27%) subjects 27 cases grade I radiation-related toxicities were
found; 9 (33%) of those 27 cases were clinically silent. In 14 (19%) females only grade I
toxicities were observed. Grade III-IV toxicities were found in 5 (6.8%) subjects. No grade II,
IV, or V toxicities were observed.

We concluded that severe late side effects caused by radiotherapy were exceedingly
rare in females successfully treated for early-stage cervical carcinoma, only 1 bilateral
osteonecrosis, 2 cases of ileus, and 2 potentially radiation-induced tumors were found. The
majority of radiation-related comorbidities found on imaging scans were clinically silent.