Abstract
During radiotherapy treatment for cervical cancer, up to 84% of patients exhibit some form of acute radiation toxicity (ART). The primary aim of this clinical study is to determine the impact of angiotensin-converting enzyme (ACE) inhibitors, β-blockers and other risk factors such as the patient’s anatomical characteristics on ART emergence in patients with locally advanced cervical cancer treated by chemoradiotherapy. This is a combination of two nested case–control studies within the cohort of patients with locally advanced cervical cancer based on the analysis of potential risk factors for the onset of ART in patients treated with 3D conformal radiotherapy (3D-CRT) and 2D conventional radiotherapy (2D-RT), prospectively followed up from January 2017 to September 2018 in a tertiary care hospital. The ACE inhibitors and bladder volume were identified as factors that significantly affect the occurrence of ART in patients treated with 3D-CRT. In patients treated with 2D-RT, the factors that significantly affect the occurrence of ART were ACE inhibitors, body mass index (BMI), brachytherapy rectal and bladder dose. This study has shown that BMI, radiation dose received by the bladder and rectum are of exceptional importance for the occurrence of the ART and also that therapy with ACE inhibitors was associated with the decreased chances of the ART.
Highlights
Cervical cancer is the fourth most common malignancy among women [1]
This study has shown that Body mass index (BMI), radiation dose received by the bladder and rectum are of exceptional importance for the occurrence of the acute radiation toxicity (ART) and that therapy with angiotensin-converting enzyme (ACE) inhibitors was associated with the decreased chances of the ART
The primary aim of this clinical study is to determine the impact of ACE inhibitors, β-blockers and other potential risk factors such as the patient’s pelvic and anatomical characteristics on ART emergence in patients with locally advanced cervical cancer treated by chemoradiotherapy
Summary
Cervical cancer is the fourth most common malignancy among women [1]. The gold-standard treatment for locally advanced cervical cancer (Federation Internationale de Gynecologie etd’ Obstetrique (FIGO) stage IIb to IVa) is concurrent chemoradiotherapy (CCRT), including chemotherapy with external beam radiotherapy (EBRT), followed by brachytherapy [2,3]. There is ample incentive to work on the timely and accurate identification and monitoring of patients at an increased risk of developing ART. It is unknown whether the individual therapy, prescribed for the treatment of other nononcological diseases, during radiation can contribute to the emergence and severity of ART. The primary aim of this clinical study is to determine the impact of ACE inhibitors, β-blockers and other potential risk factors such as the patient’s pelvic and anatomical characteristics on ART emergence in patients with locally advanced cervical cancer treated by chemoradiotherapy
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