Influence of late radiation complications on long-term survival of patients treated with irradiation of the pelvic organs

Abstract

Background. Radiation therapy is one of the main treatments for locally advanced cancers of the rectum, cervix, and prostate. As a result of summing up high total doses, radiation damage occurs in patients.Aim. To determine the frequency of late radiation injuries in patients, their impact on overall survival and quality of life.Materials and methods. The study included 759 patients who received treatment in medical facilities in St. Petersburg and the Leningrad Region, of which 324 were men and 435 were women aged 27–88 years, with a diagnosis of rectal cancer – 257, cervical cancer – 327, prostate cancer – 175 patients. Irradiation was carried out on linear accelerators and brachytherapy devices. The quality of life of patients was assessed by questionnaires based on QLQ-30.Results. The overall toxicity was 35.01 % in patients with cervical cancer, 10.4 % in patients with rectal cancer and 7.6 % in patients with prostate cancer. Overall long-term 5 and 10 years survival in patients with late complications was 46.3 and 16.5 %versus66.5 and 33.4 % in patients without late complications (p= 0.001). In patients diagnosed with rectal cancer, it was significantly higher than in other groups (p<0.05). 3–5 weeks after the end of radiation therapy, patients reported a significant deterioration in the quality of life.Conclusion. Late radiation damage is an important prognostic factor influencing long-term survival in patients diagnosed with cancer of the rectum, cervix and prostate. A decrease in the quality of life in patients who received irradiation of the pelvic organs 3–5 weeks after the end of radiation therapy has been proven.